Prognostic value of copeptin in patients with acute pulmonary thromboembolism

Abstract

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.

Predictive value of plasma copeptin level for diagnosis and mortality of pulmonary embolism

“…Copeptin is released into the blood circulation in life-threatening stress conditions. These include heart failure 11 , acute coronary syndrome 8 , sepsis 18 , pulmonary hypertension 19 , and acute PE [13][14][15] .…”

“…Thus, copeptin may show a new pathophysiological axis of PE by reflecting a systemic reaction to impaired hemodynamics due to RV dysfunction in acute PE. Some studies have reported that copeptin may be a highly significant prognostic marker in early mortality and risk stratification in patients with acute PE [13][14][15] . In this study, we investigated the copeptin Biochemical analyses Blood samples were collected from patients and the control group within a maximum of six hours after the diagnosis of acute PE to evaluate the acute phase.…”

Copeptin: a potential blood biomarker for acute ischemic stroke

“…Furthermore, Deveci and colleagues [35] found that the increase of plasma copeptin level may indicate that the patient needs further evaluation, especially since copeptin level is elevated in life-threatening conditions, such as acute myocardial infarction, shock, heart failure, pneumonia, pulmonary thromboembolism and renal failure.…”

Copeptin and Stress

“…Also, copeptin levels were inversely correlated both with oxygen saturation and echocardiographic indexes of right ventricle dilatation and pulmonary hypertension, the latter pointing out a role for copeptin as a prognostic biomarker of obstructive cardiogenic shock in APE. Several studies on large cohorts support this assumption by showing copeptin measurement could help stratifying the short-term risk of death after APE [55][56][57][58]. Wyzgał et al found significantly higher median copeptin levels in non-survivors than in survivors (84.6 vs. 18.7 pmol/L, n = 107), as well as in patients with complicated than with benign clinical course (53.1 vs. 18.2 pmol/L), the former being predicted by copeptin levels ≥ 18.0 pmol/L (AUC 0.811) [55].…”