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

Purroy, Francisco; Suárez-Luis, I; Cambray, Serafí; Farré, Joan; Benabdelhak, Ikram; Mauri-Capdevila, Gerard; Sanahuja, Jordi; Quílez, Alejandro; Begué, R.; Gil, Myung Cheol; Molina-Seguin, Jessica; Torreguitart, Nuria

doi:10.1111/ane.12523

Cited by 15 publications

(19 citation statements)

References 35 publications

(43 reference statements)

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“…Also, in that study, it was stated that higher copeptin levels improved the prognostic value of the ABCD2 score for the prediction of stroke after TIA (18). Purroy and Katan reported similar results in their studies (20,21). Even though differences regarding the sample size and methodology were present between the mentioned studies and ours, our results were consistent with the literature.…”

Section: Discussionsupporting

confidence: 90%

Aci̇l Servi̇ste Geçi̇ci̇ İskemi̇k Atak Tespi̇ti̇nde Bi̇yobeli̇rteç Olarak Serum Kopepti̇n Düzeyi̇: Prospekti̇f Bi̇r Vaka Kontrol Çalişmasi

Armağan

Yilmaz

Yürekli

et al. 2021

SDÜ Tıp Fakültesi Dergisi

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AmaçAcil Servise (AS) başvuran TİA (Geçici iskemik atak) tanısı almış hastaların plazma kopeptin düzeylerini sağlıklı kontrollerle karşılaştırarak TİA saptamak için kopeptin'in tanısal doğruluğunu araştırmayı amaçladık. Gereç ve YöntemAcil servise nörolojik bir semptomla başvuran hastalar arasında ileriye dönük bir vaka kontrol çalışması yaptık. Nörolog tarafından TİA tanısı konan hastalar dahil edildi. 38 hastanın elektrokardiyografi, manyetik rezonans görüntüleme ve karotis doppler ultrasonografi tetkik sonuçları; Acil servis sonuçları (hastaneye yatış, taburculuk), risk grubu dağılımı (ABCD2 puanlarına göre) ve bir yıllık tekrar olay insidansına ilişkin değişkenler karşılaştırıldı. Ayrıca hastaların serum kopeptin düzeyleri sağlıklı kontrollerle karşılaştırıldı. BulgularOrtalama kopeptin düzeyi hasta grubunda 435.80 ± 316.45 pg/ml iken kontrol grubunda 770.20 ± 912.53 pg/ml idi. TİA'lı hastaların ortalama kopeptin düzeyi anlamlı olarak daha düşüktü (p = 0.018). TİA tanısında tüm katılımcılarda kopeptin 386.28 pg/ml cut-off değerinde %60.53 duyarlılık ve %68.42 özgüllüğe sahipti. Ayrıca 60 yaş üstü katılımcılarda kopeptin 460.37 pg/ml cut-off değerinde %75.86 duyarlılık ve %72.41 özgüllüğe sahipti. SonuçBildiğimiz kadarıyla bu, bir serum biyobelirteçlerinin TİA tanısında yüksek etkinliğini gösteren ilk çalışmadır. Klinik şüphesi düşük ve kopeptin değeri düşük olan hastalarda acil hekimleri alternatif tanıları araştırmalıdır.

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Section: Discussionsupporting

confidence: 90%

Aci̇l Servi̇ste Geçi̇ci̇ İskemi̇k Atak Tespi̇ti̇nde Bi̇yobeli̇rteç Olarak Serum Kopepti̇n Düzeyi̇: Prospekti̇f Bi̇r Vaka Kontrol Çalişmasi

Armağan

Yilmaz

Yürekli

et al. 2021

SDÜ Tıp Fakültesi Dergisi

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“…Thirty-nine articles met eligibility criteria (37 individual study cohorts). There were 33 reports from 30 studies for CRP, 21–53 14 reports from 16 studies for fibrinogen 21,36–39,42–44,47,54–58 and 10 studies for IL-6 (Figure 1). 21,24,37–40,43,47,48,59…”

Section: Resultsmentioning

confidence: 99%

Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence after ischaemic stroke: Systematic review and meta-analysis

McCabe

O’Reilly

Coveney

et al. 2021

European Stroke Journal

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Background Recent randomised trials showed benefit for anti-inflammatory therapies in coronary disease but excluded stroke. The prognostic value of blood inflammatory markers after stroke is uncertain and guidelines do not recommend their routine measurement for risk stratification. Methods We performed a systematic review and meta-analysis of studies investigating the association of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19. Random-effects meta-analysis was performed for studies reporting comparable effect measures. Results Of 2,515 reports identified, 39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n = 16). An association with recurrent stroke was reported in 12/26 studies (CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis of comparable studies, CRP was associated with an increased risk of recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD) increase in loge-CRP (1.14, 95% CI 1.06–1.22, p < 0.01)] and MVEs (pooled HR 1.21, CI 1.10–1.34, p < 0.01). Fibrinogen was also associated with recurrent stroke (HR 1.26, CI 1.07–1.47, p < 0.01) and MVEs (HR 1.31, 95% CI 1.15–1.49, p < 0.01). Trends were identified for IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97–1.41, p = 0.10) and MVEs (HR 1.22, CI 0.96–1.55, p = 0.10). Conclusion Despite evidence suggesting an association between inflammatory markers and post-stroke vascular recurrence, substantial methodological heterogeneity was apparent between studies. Individual-patient pooled analysis and standardisation of methods are needed to determine the prognostic role of blood inflammatory markers and to improve patient selection for randomised trials of inflammatory therapies.

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“…Our prospective study evaluated the correlation of a panel of different biomarkers with infarct size. We combined biomarkers of inflammation, atrial dysfunction and neuronal and glial dysfunction 5,11,16 and observed that IL‐6 and S100b levels were able to be independently associated with infarct volume. In contrast to the other biomarkers, their correlation remained unchanged after the multivariate analyses adjusted for stroke aetiology.…”

Section: Discussionmentioning

confidence: 99%

Basal IL‐6 and S100b levels are associated with infarct volume

et al. 2021

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Objectives The study of biomarkers related to the infarct volume of acute ischaemic stroke (AIS) is a valuable clinical strategy. We conducted a prospective study to evaluate the relationship between a wide panel of biomarkers involved in different biochemical pathways and lesion volume. Materials & Methods We studied 332 patients with AIS. Infarct volume was calculated from diffusion weighted imaging (DWI). Blood samples were drawn within 24 h of symptom onset to test a panel of biomarkers that included high‐sensitivity C‐reactive protein (hs‐CRP), IL‐6, neuron‐specific enolase (NSE), N‐terminal pro‐B‐type natriuretic peptide (NT‐ProBNP), S100b, troponin and IL‐10. Results The median lesion volume was 2.5 cc (IQR: 0.6–15.3). Patients with previous atrial fibrillation, cardioembolic aetiology and total anterior circulation infarct TACI classification had higher lesion volumes than those without them. Patients with previous recent TIA had smaller ischaemic lesions than those without it. Age and NIHSS were significantly correlated with lesion volume. In a linear regression analysis adjusted by aetiology, S100b and IL‐6 emerged as the only biomarkers independently associated with infarct volume. In contrast, previous recent TIA and small‐vessel disease were inversely related to infarct volume. Conclusions The correlation between the two blood marker levels and ischaemic lesion volume would support the use of these biomarkers as a surrogate endpoint in AIS, especially in centres without DWI 24/7 but these could not substitute basic neuroimaging. Our findings should be further explored in larger, preferably multicentre studies.

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

Abstract: Serum copeptin could be an important prognostic biomarker to guide management decisions among TIA patients. Therefore, TIA patients with copeptin levels below 13.8 pmol/l and without LAA have an insignificant risk of 7-day SR and could be managed on an outpatient basis.

Cited by 15 publications

References 35 publications

Aci̇l Servi̇ste Geçi̇ci̇ İskemi̇k Atak Tespi̇ti̇nde Bi̇yobeli̇rteç Olarak Serum Kopepti̇n Düzeyi̇: Prospekti̇f Bi̇r Vaka Kontrol Çalişmasi

Aci̇l Servi̇ste Geçi̇ci̇ İskemi̇k Atak Tespi̇ti̇nde Bi̇yobeli̇rteç Olarak Serum Kopepti̇n Düzeyi̇: Prospekti̇f Bi̇r Vaka Kontrol Çalişmasi

Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence after ischaemic stroke: Systematic review and meta-analysis

Basal IL‐6 and S100b levels are associated with infarct volume

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