Copeptin
AVPpeptideCopeptin is released in response to myocardial ischemia and necrosis, providing early detection of acute coronary syndrome alongside cardiomyocyte injury.
Pathway placement
Cascade stepMyocardial injury (shared endpoint)
Confidencehigh
RationaleEarly neuroendocrine marker of cardiac injury and acute MI detection.
Also acts inSystemic / off-pathway
Druggability
DruggableYes
Known drugs / candidates0
Small-molecule tractableYes
Antibody tractableYes
EnsemblENSG00000101200
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I67
C — confounder / Type-II58
A — assay feasibility84
E — evidence strength42
T1DI (composite)23
Specificity differential (R−C)+32.3
Direct evidence: higher in Type I (D=+2)
Copeptin levels were significantly elevated in T1MI compared to T2MI patients, supporting differentiation between the two MI types.
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationmag 2
4tachyarrhythmian/a
5hypoxemia / respiratory failuren/a
6hypertensive emergencymag 1
7high-demand / peri-operative stressmag 2
Coverage: 4/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 19 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · K2/K3-EDTA (lavender-top)
Method / principle
Automated sandwich immunofluorescent/immunoluminometric assay
Reagent / substrate
Anti-copeptin antibody pair (Thermo BRAHMS)
Platform
Kryptor/automated; some POC
Turnaround · availability
Rapid (~10–30 min) · CE-marked; US research/limited
Human genetic evidence
0.016
Open Targets association (STEMI)
Literature evidence(14)
- Copeptin, miRNA-208, and miRNA-499 as New Biomarkers for Early Detection of Acute Coronary Syndrome.Applied biochemistry and biotechnology · 2021 · PMID 34637111 · doi
- The comparative and added prognostic value of biomarkers to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all-cause mortality in patients who undergo noncardiac surgery.The Cochrane database of systematic reviews · 2021 · PMID 34931303 · doi
- Copeptin as a prognostic biomarker in acute myocardial infarction.International journal of cardiology · 2018 · PMID 30217427 · doi
- Prospective diagnostic and prognostic study of copeptin in suspected acute aortic syndromes.Scientific reports · 2018 · PMID 30425269 · doi
- Novel biomarkers of cardiovascular disease: Applications in clinical practice.Critical reviews in clinical laboratory sciences · 2018 · PMID 30457415 · doi
- Novel biomarkers predicting cardiac function after acute myocardial infarction.British medical bulletin · 2016 · PMID 27418651 · doi
- Copeptin testing in acute myocardial infarction: ready for routine use?Disease markers · 2015 · PMID 25960596 · doi
- Overview of cardiac markers in heart disease.Clinics in laboratory medicine · 2014 · PMID 24507783 · doi
- Emerging biomarkers for acute heart conditions.Current opinion in cardiology · 2014 · PMID 24806784 · doi
- [Essential cardiac biomarkers in myocardial infarction and heart failure].Herz · 2014 · PMID 25091086 · doi
- Potential clinical application of novel cardiac biomarkers for acute myocardial infarction.Acta medica Indonesiana · 2013 · PMID 24045397
- Novel biomarkers in diagnosing cardiac ischemia in the emergency department: a systematic review.Resuscitation · 2011 · PMID 22200578 · doi
- Biomarkers in acute myocardial infarction.BMC medicine · 2010 · PMID 20529285 · doi
- Novel biomarkers in cardiovascular disease: update 2010.American heart journal · 2010 · PMID 20934551 · doi
Clinical trials(5)
- Copeptin Helps in the Early Detection Of Patients With Acute MyocardialNCT00952744 · COMPLETED
- The Effect of Integrating the Biomarker Copeptin Into the Process of Managing Patients With Suspected ACSNCT01498731 · NA · COMPLETED · Discharge home
- Copeptin Registry (proCORE) Biomarkers in Cardiology (BIC)-19NCT02490969 · COMPLETED · Routine management observation
- Accelerated Rule-Out of Acute Myocardial Infarction, Using Copeptin and High Sensitive Troponin T - the AROMI TrialNCT02666326 · NA · COMPLETED · Accelerated, combined biomarker rule-out strategy for MI
- Applying Novel Biomarkers to Identify MINOCA Rapidly and the Prognostic Value of Novel Biomarkers Among Patients With Acute Chest Pain: a Clinical StudyNCT04974320 · UNKNOWN · blood biomarkers