Temporal Release Pattern of Copeptin and hsTnT in Patients with Suspected ACS and spontaneous AMI –Supplemental File

Clinical characteristics of all patients and in diagnosis subgroups(sTable 1)

Clinical characteristic / All patients
(n=93) / STEMI
(n=37) / NSTEMI
(n=20) / UAP
(n=20) / Other
(n=16)
BMI
Median (IQR) / 27.2
(24.6-30.0) / 27.7
(25.4-29.9) / 26.4
(24.5-28.9) / 29.1
(24.3-30.0) / 25.6
(21.3-31.4)
Symptoms
SOT [min]
Median (IQR) / 150
(90-300) / 150
(100-263) / 120
(75-440) / 120
(90-555) / 248
(109-469)
Typical AP % (n) / 73.3 (66) / 77.8 (28) / 88.9 (16) / 75.0 (15) / 43.8 (7)
Dyspnea % (n) / 45.6 (41) / 44.4 (16) / 33.3 (6) / 45.0 (9) / 62.5 (10)
Vegetative
symptoms % (n) / 67.8 (61) / 86.1 (31) / 50.0 (9) / 55.0 (11) / 62.5 (10)
Palpitations % (n) / 10.0 (9) / 5.6 (2) / 0 / 15.0 (3) / 25.0 (4)
ECG
Sinus rythm % (n) / 82.4 (75) / 88.6 (31) / 75.0 (15) / 95.0 (19) / 62.5 (10)
AF % (n) / 7.7 (7) / 0 / 5.0 (1) / 5.0 (1) / 31.3 (5)
VF % (n) / 6.6 (6) / 2.7 (1) / 20.0 (4) / 0
AV-Block II-III° % (n) / 4.3 (4) / 8.1 (3) / 0 / 0 / 6.3 (1)
ST-elevations % (n) / 40.7 (37) / 97.1 (13) / 0 / 0 / 18.8 (3)
CA % (n) / 76.7 (69) / 91.9 (34) / 88.9 (16) / 60.0 (12) / 43.8 (7)
LAD-stenosis > 50%
% (n) / 58.2 (39) / 54.5 (18) / 73.3 (11) / 75.0 (9) / 14.3 (1)
LCX-stenosis >50%
% (n) / 50.7 (36.6) / 54.5 (18) / 53.3 (8) / 58.3 (7) / 14.3 (1)
RCA-stenosis >50%
% (n) / 67.2 (45) / 66.7 (22) / 73.3 (11) / 91.7 (11) / 14.3 (1)
Lysis % (n) / 24.7% (23) / 43.2% (16) / 35.0% (7) / 0 / 0

Supplemental table 1: Abbreviations: AF – atrial fibrillation; AP – angina pectoris; BMI – body mass index; IQR – inter quartile ranges; LAD – left anterior descending coronary artery; LCX – left circumflex coronary artery; NSTEMI – non-ST-elevation myocardial infarction; RCA – right coronary artery; SOT – symptom onset time; STEMI – ST-elevation myocardial infarction; UAP – unstable angina pectoris; VF – ventricular fibrillation

Temporal release pattern of hsTnT (Supplemental figure 1)

Supplemental figure 1 shows median hsTnT values over time in different diagnoses.Abbreviations: AMI – acute myocardial infarction; NSTEMI – non ST-elevation myocardial infarction; STEMI – ST-elevation myocardial infarction; UAP – unstable angina pectoris

Temporal release pattern of other cardiac markers (Supplemental figure 2a-c)

Temporal release pattern of C-reactive protein (CRP) in different diagnoses

Supplemental figure 2a: Median CRP-values over time in different diagnoses. Abbreviations: CRP – C-reactive protein; NSTEMI – non ST-elevation myocardial infarction; STEMI – ST-elevation myocardial infarction; UAP – unstable angina pectoris

Temporal release pattern of myoglobin in different diagnoses

Supplemental figure 2b: Median myoglobin-values over time in different diagnoses. Abbreviations: NSTEMI – non ST-elevation myocardial infarction; STEMI – ST-elevation myocardial infarction; UAP – unstable angina pectoris

Temporal release pattern of contemporary sensitive cTnT in different diagnoses

Supplemental figure 2c: Median values of contemporary sensitivecTnT (BoehringerIngelheim) over timein different diagnoses. Abbreviations: NSTEMI – non ST-elevation myocardial infarction; STEMI – ST-elevation myocardial infarction; cTnT – cardiac Troponin; UAP – unstable angina pectoris

Initially copeptin negative patients with Ami(sTable 2)

Diagnosis / Copeptin ambulance
(pmol/l) / Copeptin admission
(pmol/l) / hsTnT ambulance
(ng/l) / hsTnT admission
(ng/l) / SOT
(min)
Patient 1 / NSTEMI / . / 1.67 / . / 604.50 / 550
Patient 2 / NSTEMI / . / 5.45 / . / 195.90 / 930
Patient 3 / NSTEMI / 4.46 / 4.32 / 48.95 / 69.55 / 3,510
Patient 4 / NSTEMI / 5.61 / 5.57 / 904.10 / 1,061.00 / 440
Patient 5 / STEMI / 4.87 / 4.30 / 52.02 / 96.64 / 300
Patient 6 / STEMI / 4.91 / 4.10 / 86.72 / 170.10 / 480
Patient 7 / STEMI / 7.35 / 5.97 / 241.20 / 326.60 / 225

Supplementaltable 2 shows the diagnosis, biomarker values and symptom onset time (SOT) for all patient with AMI who were initially copeptin negative inthe ambulance or at admission (n=7). All patients had elevated hsTnT values and presented late after symptom onset. Abbreviations: AMI – acute myocardial infarction; hsTnT – high-sensitive troponin T; NSTEMI – non ST-elevation myocardial infarction; SOT – symptom onset time; STEMI – ST-elevation myocardial infarction

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