CARDIOVASCULAR DISEASE AND STROKE (P PERRONE-FILARDI AND S. AGEWALL, SECTION EDITORS) Copeptin—Marker of Acute Myocardial Infarction

# The Author(s) 2014. This article is published with open access at Springerlink.com Abstract The concentration of copeptin, the C-terminal part of pro-arginine vasopressin, has been shown to increase early after acute and severe events. Owing to complementary path-ophysiology and kinetics, the unspecific marker copeptin, in combination with highly cardio-specific troponin, has been evaluated as an early-rule-out strategy for acute myocardial infarction in patients presenting with signs and symptoms of acute coronary syndrome. Overall, most studies have reported a negative predictive value between 97 and 100 % for the diagnosis of acute myocardial infarction in low- to intermediate-risk patients with suspected acute coronary syn-drome. Additionally, a recent multicenter, randomized process study, where patients who tested negative for copeptin and troponin were discharged from the emergency department, showed that the safety of the new process was comparable to that of the current standard process. Further interventional trials and data from registries are needed to ensure the effec-tiveness and patient benefit of the new strategy