Clinical relevance of copeptin plasma levels as a biomarker of disease severity and mortality in critically ill patients

Koch, Alexander; Yagmur, Eray; Hoss, Alexander; Buendgens, Lukas; Herbers, Ulf; Weiskirchen, Ralf; Koek, Ger H.; Tacke, Frank

doi:10.1002/jcla.22614

Cited by 25 publications

(27 citation statements)

References 28 publications

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“…Our data and studies in the literature suggest the increased copeptin and creatinine concentrations in adult trauma patients might share only some pathophysiological stimuli (e.g. hypoperfusion), while copeptin may possibly contribute to further development of acute kidney failure by enhancing endothelial dysfunction and increasing systemic vascular tone [34].…”

Section: Discussionsupporting

confidence: 48%

“…Several studies suggest that increased copeptin serum concentrations can be detected in chronic kidney disease and that its level may predict future development of chronic kidney failure in a population free from kidney disease at baseline [32,33]. A correlation between copeptin and creatinine levels was found also in severely-ill patients with acute kidney injury, even if evidence is still scarce [34]. Looking at our data, while we confirm that a weak but positive correlation exists even in our trauma cohort between these two biomarkers (Spearman's rho 0.297; 95%CI 0.129-0.450, P = 0.0008), we found copeptin predictive value to be significantly superior to that of creatinine for all primary and secondary outcomes of the study (P < 0.05 for all pairwise ROC curve comparisons, data not shown).…”

Section: Discussionmentioning

confidence: 99%

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Serum Copeptin levels in the emergency department predict major clinical outcomes in adult trauma patients

et al. 2020

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Background: Early prognostication in trauma patients is challenging, but particularly important. We wanted to explore the ability of copeptin, the C-terminal fragment of arginine vasopressin, to identify major trauma, defined as Injury Severity Score (ISS) > 15, in a heterogeneous cohort of trauma patients and to compare its performances with lactate. We also evaluated copeptin performance in predicting other clinical outcomes: mortality, hospital admission, blood transfusion, emergency surgery, and Intensive Care Unit (ICU) admission. Methods: This single center, pragmatic, prospective observational study was conducted at Arcispedale Santa Maria Nuova, a level II trauma center in Reggio Emilia, Italy. Copeptin determination was obtained on Emergency Department (ED) arrival, together with venous lactate. Different outcomes were measured including ISS, Revised Trauma Score (RTS), hospital and ICU admission, blood transfusion, emergency surgery, and mortality. Results: One hundred and twenty five adult trauma patients admitted to the ED between June 2017 and March 2018. Copeptin showed a good ability to identify patients with ISS > 15 (AUC 0.819). Similar good performances were recorded also in predicting other outcomes. Copeptin was significantly superior to lactate in identifying patients with ISS > 15 (P 0.0015), and in predicting hospital admission (P 0.0002) and blood transfusion (P 0.016). Comparable results were observed in a subgroup of patients with RTS 7.84. Conclusions: In a heterogeneous group of trauma patients, a single copeptin determination at the time of ED admission proved to be an accurate biomarker, statistically superior to lactate for the identification of major trauma, hospital admission, and blood transfusion, while no statistical difference was observed for ICU admission and emergency surgery. These results, if confirmed, may support a role for copeptin during early management of trauma patients.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Serum Copeptin levels in the emergency department predict major clinical outcomes in adult trauma patients

et al. 2020

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“…Copeptin has been shown to predict prognosis in acute coronary syndrome, chronic heart failure, pulmonary hypertension and sepsis . Increased copeptin levels have been found in patients with renal insufficiency or diabetes mellitus .…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of copeptin in patients with acute pulmonary thromboembolism

Deveci

Öner

Telo

et al. 2019

Clinical Respiratory J

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Background and Aims The aim of this study was to determine the level of copeptin, which is one of the new cardiac markers in acute pulmonary thromboembolism (PE) cases, and to determine the relationship between the severity of the disease, risk classification and hospital, first month, third month and 3‐month total mortality. Methods The study included 100 cases with PE and 60 healthy control subjects. Copeptin was measured in control group. The risk grade of the cases was determined according to the sPESI index. Patients survival data at the first and third months were determined. This study was performed in patients with strict exclusion criteria for comorbidities known to be associated with increased risk of PE. Results sPESI was ≥1 in 68 (68%) of patients with acute PE. Mean serum copeptin levels were found statistically higher in patients with high risk compared to low‐risk cases and controls (9.18 ± 3.29, 6.47 ± 2.29, and 5.26 ± 2.15, P < 0.0001, respectively). When the cut‐off value of copeptin was taken as ≥7.87 with ROC analysis for predicting high sPESI score, the sensitivity of the copeptin was 78% and the specificity was 62% (AUC = 0.74, 95% CI = 0.63–0.85, P < <0.0001). When cases divided in the groups according to the cut‐off value as 7.87, first month hospital mortality and 3‐month total mortality rate was found statistically higher in patients with copeptin ≥7.87 (χ2 = 5.33 P < 0.05, χ2 = 3.88, P < 0.05 and χ2 = 4.26, P < 0.05 respectively). Conclusions The results of our study showed that increased serum copeptin levels might predict the severity of PE as well as a promising marker of early mortality in high‐risk cases according to sPESI.

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“…N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a well-established diagnostic marker of heart failure [13] and an important predictor of mortality in patients with heart failure [13] or ACS [14]. Both NT-proBNP [15,16] and copeptin [17,18] have been found to predict mortality in critically ill patients admitted to a medical intensive care unit (ICU).…”

Section: Introductionmentioning

confidence: 99%

N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Indicator for 30-Day Mortality Following Out-of-Hospital Cardiac Arrest: A prospective observational study

Aarsetøy¹,

Omland

Røsjø

et al. 2020

Preprint

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Background Early risk stratification applying cardiac biomarkers may prove useful in sudden cardiac arrest patients. We investigated the prognostic utility of early-on levels of high sensitivity cardiac troponin-T (hs-cTnT), copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with out-of-hospital cardiac arrest (OHCA). Methods We conducted a prospective observational unicenter study, including patients with OHCA of assumed cardiac origin from the southwestern part of Norway from 2007 until 2010. Blood samples for later measurements were drawn during cardiopulmonary resuscitation or at hospital admission. Results A total of 114 patients were included, 37 patients with asystole and 77 patients with VF as first recorded heart rhythm. Forty-four patients (38.6%) survived 30-day follow-up. Neither hs-cTnT (p = 0.49), nor copeptin (p = 0.39) differed between non-survivors and survivors, whereas NT-proBNP was higher in non-survivors and significantly associated with time to death, with a hazard ratio (HR) for patients in the highest compared to the lowest quartile of 4.6 (95% CI 2.1–10.1), p < 0.001. This association was attenuated in the multivariable analysis [HR 2.18 (95% CI 0.83–5.72)], p = 0.11. NT-proBNP was significantly higher in asystole- as compared to VF-patients, p < 0.001. Conclusions In OHCA, NT-proBNP was significantly associated with 30-day survival in univariate analysis, but associations were attenuated after multivariable adjustment. Hs-cTnT and copeptin did not provide prognostic information following OHCA. Clinical Trial Registration: ClinicalTrials. gov, NCT02886273.

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Clinical relevance of copeptin plasma levels as a biomarker of disease severity and mortality in critically ill patients

Abstract: Copeptin plasma concentrations are significantly elevated in critically ill patients, correlate with disease severity and predict ICU and long-term outcome. Thus, copeptin could be a promising tool for prognostication and management of critically ill patients.

Cited by 25 publications

References 28 publications

Serum Copeptin levels in the emergency department predict major clinical outcomes in adult trauma patients

Serum Copeptin levels in the emergency department predict major clinical outcomes in adult trauma patients

Prognostic value of copeptin in patients with acute pulmonary thromboembolism

N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Indicator for 30-Day Mortality Following Out-of-Hospital Cardiac Arrest: A prospective observational study

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