الفهرس 
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Abstract
Acute pulmonary embolism (APE) is a common disease which, if not properly diagnosed and treated, is associated with significant morbidity and mortality rates that can reach 17.4%. As the presenting symptoms and signs are nonspecific, diagnostic tests are necessary to establish the presence or absence of PE in order to avoid the risks of unnecessary anticoagulation or fatal thromboembolic recurrence that can occur if APE is left untreated. Early diagnosis and risk stratification and improved inpatient management may yield better short- and long-term prognoses. The use of inexpensive, easy-to-use and readily available measurements of biomarkers may be beneficial. Some proven efficacy biomarkers such as D-dimer, B-type natriuretic peptide (BNP), and troponin I are used in the diagnosis and risk stratification of APE. Copeptin, the C-terminal portion of pro-vasopressin, is a glycosylated polypeptide comprised of 39 amino acids and harboring a leucine-rich core segment. The diagnostic and prognostic utility of copeptin was reported in some acute illnesses such as sepsis, pneumonia, lower respiratory tract infections, and stroke.In addition, the usefulness and accuracy of copeptin for diagnosis and risk stratification of cardiovascular diseases were investigated in recent studies and it was found that copeptin combined with troponin T enhanced the accuracy in the diagnosis of acute myocardial infarction (AMI) and in the prognosis of heart failure. Furthermore, high copeptin levels were reported to be associated with worse outcomes in patients who were admitted to the Emergency Department with dyspnea. The current study was aimed to assess the diagnostic value of serum copeptin in acute pulmonary embolism. This study conducted on 30 cases divided into 20 patients and 10 controls. In this study: There was no statistical significant difference between the studied groups regarding the age and gender. According to clinical data, there was significant difference between patients and control groups as regard to heart rate. There was significant difference in CRP & D dimer levels which increased in patients than controls. There was statistically significant increase in copeptin level in patient group when compared to control group.. There was positive significant correlation between HR and copeptin. There was positive significant correlation between copeptin and both D Dimer & CRP. The cut off value of copeptin to differentiate APE patients from controls is 4 ng/ml. This cut off value achieves sensitivity 80% and specificity 85%. The cut off level for D Dimer in discriminating APE patients from control group was 350 ng/ml. This cut off value achieves sensitivity of 85%, specificity of 90%. Simaltaneous use of copeptin & D Dimer as adiagnostic biomarkers of APE achieves sensitivity of 90%, specificity of 95%.