Copeptin: a potential blood biomarker for acute ischemic stroke

Abstract

Background Copeptin is a new blood biomarker for acute ischemic stroke which emerged to assist clinicians with decision-making. Serum copeptin can accurately reflect vasopressin concentration, which plays a role in aggravation of inflammatory responses, ions and neurotransmitters dysfunctions. The objective of this work was to investigate the relation between copeptin level as a blood biomarker and the short-term prognosis of acute ischemic stroke after 3 months. The current study included 45 patients with first ever acute ischemic stroke and 45 healthy volunteers as a control. Clinical evaluation, CT and MRI of the brain, NIHSS on admission, and mRS after 3 months were done for the patients, and all the patients and control were subjected to assessment of serum level of copeptin by ELISA technique. Results Copeptin level was significantly higher in patients with acute ischemic stroke compared to healthy control subjects (p-value = 0.001). Also, copeptin level was significantly higher in patients with severe stroke (NIHSS > 16) than in those with mild-to-moderate stroke (NIHSS 0–15) at presentation and in patients with unfavorable outcome (mRS 3–6) when compared to patients with favorable outcome (mRS 0–2) (p-value = 0.003 and 0.001, respectively). Copeptin level was significantly lower in patients who received thrombolytic therapy with rTPA (p-value = 0.049). Conclusion Copeptin has an interesting potential as a new prognostic biomarker for patients with acute ischemic stroke as its level was significantly higher in patients with severe stroke and in patients with unfavorable outcome.

Copeptin Implementation on Stroke Prognosis

“…They were classified into 4 groups, according to the type of stroke investigated. The first group consisted of twelve studies focusing on the prognostic potential of serum copeptin among ischemic stroke patients [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. The second group included three studies dealing with the predictive ability of circulating copeptin levels following TIA in terms of stroke recurrence, functional outcome and mortality [ 40 , 41 , 42 ].…”

“…It is noteworthy that the evaluation of copeptin concentration within a biomarker panel is found to be coupled with greater prognostic potential following stroke than the assessment of a single blood biomarker. Moreover, in a study conducted by Oraby et al [ 32 ] it was found that elevated copeptin levels were strongly correlated with a more severe stroke, as well as poor short-term functional outcome at 3 months. In agreement with aforementioned data, the researchers reported lower plasma copeptin concentrations in the group of patients undergoing thrombolytic therapies compared to those that were not eligible for reperfusion interventions.…”

The diagnostic and prognostic value of copeptin in patients with acute ischemic stroke and transient ischemic attack: A systematic review and meta-analysis

“…AVP stimulates V1a and V2 receptors, which trigger platelet aggregation, vasoconstriction, and water retention. The above process results, are hypovolemic or normovolemic hyponatremia, and low plasma osmolality may occur [ 38 ]. Hyponatremia is a common condition in patients after stroke.…”

The association between hydration state and the metabolism of phospholipids and amino acids among young adults: a metabolomic analysis

“…Extensive research has revealed the role hydration and related hormones play in various metabolic conditions, specifically glycemic control and the onset of type II diabetes mellitus [ 2 ]. An elevated concentration of AVP and its surrogate biomarker, co-peptin, were associated with a higher incidence of cardiocerebral and metabolic diseases [ [3] , [4] , [5] ].…”