sdü tıp fak derg

Medical Journal of Süleyman Demirel University

2602-2109

Süleyman Demirel Üniversitesi

10.17343/sdutfd.970311

Clinical Sciences

Klinik Tıp Bilimleri

SERUM COPEPTIN LEVEL AS A BIOMARKER FOR DETECTING TRANSIENT ISCHEMIC ATTACK IN THE EMERGENCY ROOM: A PROSPECTIVE CASE-CONTROL STUDY

ACİL SERVİSTE GEÇİCİ İSKEMİK ATAK TESPİTİNDE BİYOBELİRTEÇ OLARAK SERUM KOPEPTİN DÜZEYİ: PROSPEKTİF BİR VAKA KONTROL ÇALIŞMASI

https://orcid.org/0000-0002-5749-3753

Armagan

Hamit Hakan

Medical Faculty of Suleyman Demirel University, Emergency Medicine Department

https://orcid.org/0000-0002-4105-2785

Karaman

Kıvanç

Medical Faculty of Muğla Sıtkı Koçman University, Emergency Medicine Department

https://orcid.org/0000-0002-5553-155X

Yalçın Yılmaz

Derya

Emergency Department of Isparta State Hospital, Isparta/TURKEY

https://orcid.org/0000-0002-2042-4463

Yürekli

Vedat Ali

Medical Faculty of Suleyman Demirel University, Department of Neurology

https://orcid.org/0000-0001-6514-2120

Önal

Özgür

Medical Faculty of Suleyman Demirel University, Department of Public Health

https://orcid.org/0000-0003-1280-3292

Şimşek

Abdurrahman

Emergency Department of Ağrı Training and Research Hospital

https://orcid.org/0000-0001-5304-1007

Şirin

Fevziye Burcu

Medical Faculty of Suleyman Demirel University, Department of Biochemistry

https://orcid.org/0000-0001-7902-1477

Beceren

Gökben

Medical Faculty of Suleyman Demirel University, Emergency Medicine Department

https://orcid.org/0000-0003-2997-1938

Tomruk

Önder

Medical Faculty of Suleyman Demirel University, Emergency Medicine Department

09 13 2021

28 3 465 471 07 12 2021 08 14 2021

1994

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

ObjectiveWe aimed to investigate the diagnostic accuracy ofcopeptin to detect transient ischemic attack (TIA) bycomparing the plasma copeptin levels of patients diagnosedwith TIA who were admitted to the EmergencyDepartment (ED) with those of healthy controls.Materials and MethodsWe conducted a prospective case-control studyamong patients admitted to the ED with a neurologicalsymptom. The patients diagnosed with TIA by theneurologist were included. The results of electrocardiography,magnetic resonance imaging, and carotiddoppler ultrasonography investigations of 38 patients;the ED outcomes (hospitalization, discharge), the riskgroup distribution (according to ABCD2 scores), andthe variables regarding one-year re-event incidencewere compared. Additionally, the serum copeptin levelsof the patients were compared to those of healthycontrols.ResultsThe mean copeptin level was 435.80 ± 316.45 pg/mlin the patient group, whereas it was 770.20 ± 912.53pg/ml in the control group. The mean copeptin level ofpatients with TIA was significantly lower (p = 0.018). Inthe diagnosis of TIA, copeptin had 60.53% sensitivityand 68.42% specificity at a cut-off value of 386.28 pg/ml, in all the participants. In addition, in participantsabove 60 years old, copeptin had 75.86% sensitivityand 72.41% specificity at a cut-off value of 460.37 pg/ml.ConclusionTo the best of our knowledge, this is the first studydemonstrating the high efficacy of a serum biomarkerin the diagnosis of TIA. Emergency physicians shouldsearch for alternative diagnoses in patients with a lowdegree of clinical suspicion and a lower copeptin value.

AmaçAcil Servise (AS) başvuran TİA (Geçici iskemik atak)tanısı almış hastaların plazma kopeptin düzeylerinisağlıklı kontrollerle karşılaştırarak TİA saptamakiçin kopeptin’in tanısal doğruluğunu araştırmayıamaçladık.Gereç ve YöntemAcil servise nörolojik bir semptomla başvuran hastalararasında ileriye dönük bir vaka kontrol çalışmasıyaptık. Nörolog tarafından TİA tanısı konan hastalardahil edildi. 38 hastanın elektrokardiyografi, manyetikrezonans görüntüleme ve karotis doppler ultrasonografitetkik sonuçları; Acil servis sonuçları (hastaneyeyatış, taburculuk), risk grubu dağılımı (ABCD2 puanlarınagöre) ve bir yıllık tekrar olay insidansına ilişkindeğişkenler karşılaştırıldı. Ayrıca hastaların serum kopeptindüzeyleri sağlıklı kontrollerle karşılaştırıldı.BulgularOrtalama kopeptin düzeyi hasta grubunda 435.80 ±316.45 pg/ml iken kontrol grubunda 770.20 ± 912.53pg/ml idi. TİA'lı hastaların ortalama kopeptin düzeyianlamlı olarak daha düşüktü (p = 0.018). TİA tanısındatüm katılımcılarda kopeptin 386.28 pg/ml cut-offdeğerinde %60.53 duyarlılık ve %68.42 özgüllüğesahipti. Ayrıca 60 yaş üstü katılımcılarda kopeptin460.37 pg/ml cut-off değerinde %75.86 duyarlılık ve%72.41 özgüllüğe sahipti.SonuçBildiğimiz kadarıyla bu, bir serum biyobelirteçlerininTİA tanısında yüksek etkinliğini gösteren ilk çalışmadır.Klinik şüphesi düşük ve kopeptin değeri düşükolan hastalarda acil hekimleri alternatif tanıları araştırmalıdır.

Arginine-vasopressin Copeptin Emergency Neurology Transient Ischemic Attack

Arginin-vazopressin Kopeptin Acil Nöroloji Geçici İskemik Atak

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