Copeptin and insulin-like growth factor binding protein-1 during follow-up after an acute myocardial infarction in patients with type 2 diabetes: A report from the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction 2 cohort

Abstract

Copeptin and insulin-like growth factor binding protein-1 analysed at admission for a myocardial infarction in patients with type 2 diabetes mellitus predicts cardiovascular events. The present aim was to study the association between copeptin and insulin-like growth factor binding protein-1, the development of the levels over time, and if the predictive value remained when measured at hospital discharge and 3 months thereafter. Methods: Copeptin and insulin-like growth factor binding protein-1 were analysed in patients (median age = 70, male = 68%) with type 2 diabetes mellitus + myocardial infarction at admission (n = 393), discharge (n = 309) and 3 months later (n = 288). The primary endpoint was cardiovascular event (cardiovascular death/non-fatal myocardial infarction/ stroke) with the three time points as separate baselines. Results: The median copeptin levels were 21.8 pmol/L at admission, 8.5 pmol/L at discharge and 8.4 pmol/L after 3 months, while insulin-like growth factor binding protein-1 levels continued to increase. There were significant correlations between the biomarkers at all occasions. During an average follow-up of 2.5 years, copeptin, but not insulin-like growth factor binding protein-1, predicted cardiovascular event at all occasions in unadjusted analyses. Copeptin remained as a predictor at discharge and after 3 months in the final multiple model (including: heart failure/age/creatinine clearance). Conclusion: The relationship between copeptin and insulin-like growth factor binding protein-1 during the initial phase of a myocardial infarction persisted in a less-stressful situation, and copeptin remained as a prognostic indicator at discharge and 3 months later.

Emerging Biomarkers for Predicting Clinical Outcomes in Patients with Heart Disease

“…In a DIGAMI substudy, copeptin levels were measured at admission ( n = 393), on discharge ( n = 309), and 3 months after MI ( n = 288) in patients with type 2 diabetes mellitus [ 70 ]. Copeptin at different time points was associated with outcomes, but the most consistent association was for admission copeptin, which maintained its predictive value in adjusted models for CV events, for CV death, and for combined non-fatal MI or stroke [ 70 ].…”

The evaluation of pituitary damage associated with cardiac arrest: An experimental rodent model

“…Compelling data indicated copeptin as an excellent predictor of outcomes of patients with heart failure and acute myocardial infarction (AMI); its accuracy was even superior to that of NT-proBNP 27,28 . Others also indicated that copeptin possessed the potential to be a surrogate marker for acute lung injury, glucose abnormalities with AMI, birth asphyxia, multiple organ dysfunction, death in the intensive care units, cardiac stress after generalized convulsive seizures, and neurological dysfunction and mortality in post-CA syndrome [29][30][31][32][33] . Moreover, CT-proAVP was reported to be associated with hypopituitarism 34 .…”

Copeptin as a novel biomarker of cardiometabolic syndrome

“…Smaradottir et al analysed copeptin levels in patients with type 2 diabetes and myocardial infarction at admission, discharge and three months later and discovered that copeptin serum concentrations at admission were significantly higher than at subsequent time points. Moreover, copeptin turned out to be a significant predictor for cardiovascular events at all time points [47].…”