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Copeptin
Pathway / Myocardial injury (shared endpoint)

Copeptin

AVPpeptide

Copeptin 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 non-Type I discrimination

ScoresShared / rises in both
R — rupture / Type-I
67
C — non-Type-I
67
A — assay feasibility
84
E — evidence strength
42
T1DI (composite)
13
Specificity differential (R−C)-24
Direct evidence: higher in non-Type I (D=-2)
Copeptin 21.4 pmol/L in T2MI/injury vs 8.1 pmol/L in T1MI (P=0.001); confirmed in external validation cohort (n=1390)
Non-Type-I axis panel
Does this marker also move in each non-Type-I setting? mag 0–3; higher means less Type-I-specific. n/a = no evidence retrieved, which is not the same as no change.
2sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
2hypovolemia / dehydrationmag 2
2tachyarrhythmian/a
2hypoxemia / respiratory failuren/a
2hypertensive emergencymag 1
2high-demand / peri-operative stressmag 2
3sudden cardiac deathmag 1
4aPCI-related periproceduralmag 3
4bstent thrombosisn/a
4cin-stent restenosisn/a
5CABG-relatedmag 3
Coverage: 7/12 axes with evidence
Tier: deep-scored (abstract-extracted) · 18 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)

Clinical trials(5)