Copeptin and Long-Term Risk of Recurrent Vascular Events After Transient Ischemic Attack and Ischemic Stroke

Abstract

Background and Purpose-Copeptin, the c-terminal portion of provasopressin, is a useful prognostic marker in patients after myocardial infarction and heart failure. More recently, high levels of copeptin have also been associated with worse functional outcome and increased mortality within the first year after ischemic stroke and transient ischemic attack (TIA). However, to date, there are no published data on whether copeptin predicts long-term risk of vascular events after TIA and stroke. Methods-We measured copeptin levels in consecutive patients with TIA or ischemic stroke in a population-based study (Oxford Vascular Study) 044).The predictive value of copeptin was largest in patients with cardioembolic index events (adjusted hazard ratio, 1.84; 95% confidence interval, 1.53-2.20 versus 1.31, 1.14-1.50 in noncardioembolic stroke; P=0.0025). In patients with cardioembolic stroke, high copeptin levels were associated with a 4-fold increased risk of vascular events within the first year of follow-up (adjusted hazard ratio, 4.02; 95% confidence interval, 2.13-7.70). Conclusions-In patients with TIA and ischemic stroke, copeptin predicted recurrent vascular events and death, particularly after cardioembolic TIA/stroke. Further validation is required, in particular, in studies using more extensive cardiac evaluation.

The determination of copeptin levels helps management decisions among transient ischaemic attack patients

“…The identification of reliable biomarkers of SR among TIA patients has been the goal of a few studies. C‐reactive protein , copeptin and lipoprotein‐associated phospholipase have recently been proposed to identify patients with high risk of subsequent stroke after TIA. Therefore, a biomarker that could be determined fast could be a diagnostic and prognostic option when an urgent MRI is unavailable.…”

The potential role of blood biomarkers in patients with ischemic stroke

“…34,35 Copeptin concentrations have been demonstrated to predict re-events after TIA and stroke, with an incremental value over the usually used clinical risk stratification models, in at least three independent studies. [36][37][38] Recently, a promising panel of three serum biomarkers-osteopontin, neopterin, and myeloperoxidase-was independently associated with the risk of recurrent stroke, and improved risk classification when added to a clinical risk algorithm with a continuous net reclassification improvement of 29.1%. 39 These results are promising.…”

Practical Experience of Humanistic Care Among Medical Staff in Stroke Wards: A Qualitative Research Study Conducted in China

“…With increasing incidences year on year [3] , stroke has become the primary leading cause of mortality in China [4] . Approximately 75% of stroke survivors have varying degrees of physical and mental disability [5] , which has become a huge burden to families and society [6,7] .…”