Copeptin & Troponin T: A Dual Biomarker Approach For Assessing The Severity In Coronary Artery Disease

Background: Cardiovascular diseases are leading causes of morbidity and mortality amounting to 25 % of the same in the Indian sub-continent. Coronary artery disease (CAD) is the most common heart disease, ranging from asymptomatic atherosclerosis and stable angina to acute coronary syndromes. Atherosclerotic plaques- the pathophysiological hallmark, need swift and deep ended comprehension for timely diagnosis subsequently leading to adequate redressal from unit patient to population levels. Copeptin, a 39-amino acid glycoprotein, being stable, is easily measurable in peripheral blood and has potential as a biomarker in cardiac diseases like heart failure and acute coronary syndromes. Troponin is a complex of three regulatory proteins (troponin C, troponin I, and troponin T) that are integral to muscle contraction. Measurements of blood level of cardiac-specific troponins I and T are extensively used as diagnostic and prognostic indicators in the management coronary artery disease. The objective of this study was to evaluate the differences in copeptin and troponins T levels between CAD patients and healthy controls as a dual biomarker approach to assess the potential of copeptin and troponins T as a dual biomarker for CAD. Methods: This observational case-control study was conducted at S.C.B Medical College and Hospital, Cuttack, from 2020 to 2022 after approved by the Institutional Ethics Committee which involved 80 CAD patients along with an equal number of age- and sex-matched controls. Exclusion criteria included acute or chronic kidney disease, traumatic heart disease, head injury, severe morbidity, or refusal to participate. copeptin and troponins T were measured by Enzyme-linked immunoassay (ELISA). Results: Severe CAD patients exhibited significantly higher copeptin and troponins T levels compared to controls as compared to moderate and mild CAD patients and the difference was statistically significant. (p<0.001) Conclusion: CAD patients exhibited higher copeptin and troponins T levels compared to healthy controls, suggesting that copeptin and troponins T can serve as a dual biomarker for CAD.