Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

Battista, Stefania; Audisio, Umberto; Galluzzo, Claudia; Maggiorotto, Matteo; Masoero, Monica; Forno, Daniela; Pizzolato, Elisa; Ulla, Marco; Lucchiari, Manuela; Vitale, Annarita; Moiraghi, Corrado; Lupia, Enrico; Settanni, Fabio; Mengozzi, Giulio

doi:10.1155/2016/3624730

Cited by 25 publications

(13 citation statements)

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“…This is the first study evaluating copeptin as a diagnostic biomarker of AAS. We found that copeptin levels in AAS are higher than reported in myocardial infarction and comparable to those found in other life-threatening conditions such as bleeding, sepsis and critical illness 11 , 12 , 14 , 16 – 18 . The sensitivity of copeptin for AAS was highest in early presenters to the ED.…”

Section: Discussionsupporting

confidence: 83%

Prospective diagnostic and prognostic study of copeptin in suspected acute aortic syndromes

Morello

Oddi

Cavalot

et al. 2018

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Acute aortic syndromes (AAS) are cardiovascular emergencies with unmet diagnostic needs. Copeptin is released upon stress conditions and is approved for rule-out of myocardial infarction (MI). As MI and AAS share presenting symptoms, stress mechanisms and necessity for rapid diagnosis, copeptin appears as an attractive biomarker also for AAS. We thus performed a diagnostic and observational study in Emergency Department (ED) outpatients. Inclusion criteria were chest/abdominal/back pain, syncope and/or perfusion deficit, plus AAS in differential diagnosis. Blood samples were obtained in the ED. 313 patients were analyzed and 105 (33.5%) were diagnosed with AAS. Median copeptin was 38.91 pmol/L (interquartile range, IQR, 16.33–173.4) in AAS and 7.51 pmol/L (IQR 3.58–15.08) in alternative diagnoses (P < 0.001). Copeptin (≥10 pmol/L) had a sensitivity of 80.8% (95% confidence interval, CI, 72.2–87.2) and a specificity of 63.6% (CI 56.9–69.9) for AAS. Within 6 hours, the sensitivity and specificity were 88.7% (CI 79.3–94.2) and 52.4% (CI 42.9–61.8) respectively. Combination with D-dimer did not increase the diagnostic yield. Furthermore, copeptin ≥25 pmol/L predicted mortality in patients with alternative diagnoses but not with AAS. In conclusion, copeptin increases in most patients with AAS within the first hours, but the accuracy of copeptin for diagnosis AAS is suboptimal.

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Section: Discussionsupporting

confidence: 83%

Prospective diagnostic and prognostic study of copeptin in suspected acute aortic syndromes

Morello

Oddi

Cavalot

et al. 2018

Sci Rep

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“…Finally, 86 studies were included after two updated searches in February 2015 and September 2016 (Fig. 1) (Abidi et al 2008; Ahmadinejad et al 2009; Al-Nawas et al 1996; Anand et al 2015; Balc et al 2003; Barati et al 2010; Battista et al 2016; Bell et al 2003; Beqja-Lika et al 2013; Carpio et al 2015; Castelli et al 2004; Clec’h et al 2006; de Pablo et al 2013; Dorizzi et al 2006; Du et al 2003; Endo et al 2012; Farag et al 2013; Feng et al 2012; Gaini et al 2006; Garnacho-Montero et al 2014; Gerrits et al 2013; Giamarellos-Bourboulis et al 2008; Gibot et al 2004; Godnic et al 2015; Guven et al 2002; Han et al 2016; Harbarth et al 2001; Hoenigl et al 2013; Hou et al 2012, 2016; Hsu et al 2011; Ishikura et al 2014; Ivancevic et al 2008; Jekarl et al 2013, 2014; Jiang et al 2015; Kim and Zhang 2012; Kofoed et al 2007; Latour-Perez et al 2010; Lewis et al 2015; Li et al 2013a; Lin et al 2015; Matera et al 2013; Mat-Nor et al 2016; Mearelli et al 2014; Meynaar et al 2011; Miglietta et al 2015; Miller et al 1999; Muthiah et al 2007, Naeini and Montazerolghaem 2006; Oshita et al 2010; Papadimitriou-Olivgeris et al 2015; Ratzinger et al 2013; Reichsoellner et al 2014; Righi et al 2014; Rivera-Chavez and Minei 2009; Rogina et al 2014; Romualdo et al 2014; Ruiz-Alvarez et al 2009; Sakr et al 2008; Scherpereel et al 2006; Schulte et al 2011; Selberg et al 2000; Seok et al 2012; Shozushima et al 2011; Sierra et al 2004; Su et al 2012, 2013; Sungurtekin et al …”

Section: Resultsmentioning

confidence: 99%

Biomarkers for diagnosis of sepsis in patients with systemic inflammatory response syndrome: a systematic review and meta-analysis

et al. 2016

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BackgroundSepsis is one of the most common diseases that seriously threaten human health. Although a large number of markers related to sepsis have been reported in the last two decades, the diagnostic accuracy of these biomarkers remains unclear due to the lack of similar baselines among studies. Therefore, we conducted a large systematic review and meta-analysis to evaluate the diagnostic value of biomarkers from studies that included non-infectious systemic inflammatory response syndrome patients as a control group.MethodsWe searched Medline, Embase and the reference lists of identified studies beginning in April 2014. The last retrieval was updated in September 2016.ResultsUltimately, 86 articles fulfilled the inclusion criteria. Sixty biomarkers and 10,438 subjects entered the final analysis. The areas under the receiver operating characteristic curves for the 7 most common biomarkers, including procalcitonin, C-reactive protein, interleukin 6, soluble triggering receptor expressed on myeloid cells-1, presepsin, lipopolysaccharide binding protein and CD64, were 0.85, 0.77, 0.79, 0.85, 0.88, 0.71 and 0.96, respectively. The remaining 53 biomarkers exhibited obvious variances in diagnostic value and methodological quality.ConclusionsAlthough some biomarkers displayed moderate or above moderate diagnostic value for sepsis, the limitations of the methodological quality and sample size may weaken these findings. Currently, we still lack an ideal biomarker to aid in the diagnosis of sepsis. In the future, biomarkers with better diagnostic value as well as a combined diagnosis using multiple biomarkers are expected to solve the challenge of the diagnosis of sepsis.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-3591-5) contains supplementary material, which is available to authorized users.

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“…Copeptin is the result of the C-terminal cleavage of the arginine-vasopressin (AVP) prohormone and it has emerged as a surrogate marker of AVP, since they are cosecreted by the posterior pituitary gland in an equimolar quantity and, unlike AVP, copeptin has optimal stability exvivo [9]. Copeptin measurement has been proposed in the early rule-out of acute myocardial infarction and in the diagnosis of diabetes insipidus, and its prognostic role has been investigated in many different clinical scenarios, including traumatic brain injury, sepsis, and stroke [10][11][12][13][14]. Copeptin determination in traumatic patients has been performed in two main studies so far, and in both of them its level was measured together with AVP [15,16].…”

Section: Introductionmentioning

confidence: 99%

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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Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

Cited by 25 publications

References 32 publications

Prospective diagnostic and prognostic study of copeptin in suspected acute aortic syndromes

Prospective diagnostic and prognostic study of copeptin in suspected acute aortic syndromes

Biomarkers for diagnosis of sepsis in patients with systemic inflammatory response syndrome: a systematic review and meta-analysis

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

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