C-Terminal Provasopressin (Copeptin) as a Novel and Prognostic Marker in Acute Myocardial Infarction

Khan, Sohail Q.; Dhillon, Onkar S.; O’Brien, Russell J.; Struck, Joachim; Quinn, Paulene A.; Morgenthaler, Nils G.; Squire, Iain B.; Davies, Joan E.; Bergmann, Andreas; Ng, Leong L.

doi:10.1161/circulationaha.106.685503

Cited by 338 publications

(311 citation statements)

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“…While several markers, such as NT-BNP, 5,20,21 CRP, [21][22][23][24] D-Dimers, 20,25,26 Interleukin-6, 21,24,27 von Willebrand factor, 28, 29 S-100β, 30 and neuron specific enolase (NSE), 31 have been associated with functional outcome or mortality, only a few biomarkers added to prognosis based on clinical assessment. None of these markers, however, were fully evaluated including assessment of accuracy (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Copeptin is a reliable prognostic marker not only in stroke patients but also in patients with cardiovascular events. 5,6 However, before implementing copeptin in clinical practice, the prognostic potential of copeptin needs to be validated in a prospective, independent, large multicenter study. Moreover, it is unclear whether copeptin predicts outcome in patients with ischemic stroke that has been treated differently, i.e.…”

Section: Introductionmentioning

confidence: 99%

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Copeptin adds prognostic information after ischemic stroke

et al. 2013

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OBJECTIVE: To evaluate and validate the incremental value of copeptin in the prediction of outcome and complications as compared with established clinical variables. METHODS: In this prospective, multicenter, cohort study, we measured copeptin in the emergency room within 24 hours from symptom onset in 783 patients with acute ischemic stroke. The 2 primary end points were unfavorable functional outcome (modified Rankin Scale score 3-6) and mortality within 90 days. Secondary end points were any of 5 prespecified complications during hospitalization. RESULTS: In multivariate analysis, higher copeptin independently predicted unfavorable outcome (adjusted odds ratio 2.17 for any 10-fold copeptin increase [95% confidence interval CI, 1.46-3.22], p < 0.001), mortality (adjusted hazard ratio 2.40 for any 10-fold copeptin increase [95% CI, 1.60-3.60], p < 0.001), and complications (adjusted odds ratio 1.93 for any 10-fold copeptin increase [95% CI, 1.33-2.80], p = 0.001). The discriminatory accuracy, calculated with the area under the receiver operating characteristic curve, improved significantly for all end points when adding copeptin to the NIH Stroke Scale score and the multivariate models. Moreover, the combination of copeptin with a validated score encompassing both the NIH Stroke Scale and age led to a net reclassification improvement of 11.8% for functional outcome and of 37.2% for mortality. CONCLUSIONS: In patients with ischemic stroke, copeptin is a validated blood marker that adds predictive information for functional outcome and mortality at 3 months beyond stroke severity and age. Copeptin seems to be a promising new blood marker for prediction of in-hospital complications. Authors Contribution:As principal investigators, Dr De Marchis (GMDM), Dr Katan (MK) and Dr Arnold (MA) had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Methods:In this prospective, multicenter cohort study we measured copeptin in the emergency room within 24 hours from symptom onset in 783 patients with acute ischemic stroke. The two primary endpoints were unfavorable functional outcome (modified Rankin Scale score 3-6) and mortality within 90 days. Secondary endpoints were any of five prespecified complications during hospitalization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Copeptin adds prognostic information after ischemic stroke

et al. 2013

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“…Together with AVP, copeptin is derived from a 164-amino-acid precursor termed preprovasopressin, which consists of a signal peptide, AVP, neurophysin II and copeptin; thus, copeptin is the C-terminal part of pro-AVP. 45 Copeptin levels are elevated after an AMI 98 and are associated with left ventricular dysfunction and remodelling and clinical heart failure post AMI. 99 Copeptin levels are affected by gender and renal function.…”

Section: Copeptinmentioning

confidence: 99%

Randomised Assessment of Treatment using Panel Assay of Cardiac markers – Contemporary Biomarker Evaluation (RATPAC CBE)

Collinson

Gaze²,

Thokala³

et al. 2013

Health Technol Assess

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Reports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/22/16. The contractual start date was in August 2010. The draft report began editorial review in February 2012 and was accepted for publication in June 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by the NIHR Journals Library, produced by Prepress Projects Ltd, Perth, Scotland (www.prepress-projects.co.uk). Objectives: To test the diagnostic accuracy for detecting an acute myocardial infarction (AMI) using highly sensitive troponin assays and a range of new cardiac biomarkers of plaque destabilisation, myocardial ischaemia and necrosis; to test the prognostic accuracy for detecting adverse cardiac events using highly sensitive troponin assays and this range of new cardiac biomarkers; and to estimate the cost-effectiveness of using highly sensitive troponin assays or this range of new cardiac biomarkers instead of an admission and 10-to 12-hour troponin measurement. NIHR Journals LibraryDesign: Substudy of the point-of-care arm of the RATPAC (Randomised Assessment ...

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“…Distinct control of copeptin and NT-proBNP secretion could have potentially contributed to their additive effect on risk stratification. Indeed, Khan et al (2007) reported that NT-proBNP and copeptin showed similar accuracy in predicting death or HF in acute myocardial infarction; however, this combination in a multimarker risk stratification approach provided greater predictive accuracy.…”

Section: Discussionmentioning

confidence: 99%