Plasma copeptin levels in Chinese patients with acute ischemic stroke: a preliminary study

Abstract

Copeptin is a stable by-product of arginine-vasopressin synthesis and reflects its secretion. The objective of the study was to evaluate the predictive value of copeptine on functional outcome at 90-day follow-up from stroke onset. We conducted a prospective, observational cohort study in the emergency department of two hospitals and enrolled 125 patients with acute ischemic stroke. Plasma copeptin concentrations, determined by a CT-proAVP-luminescence-immunoassay, were measured. There was a good correlation between levels of plasma copeptin and NIHSS score (r = 0.733, P < 0.01). In the 41 patients (32.8 %) with a poor functional outcome, copeptin levels were higher compared with those in patients with a favorable outcome (27.3; IQR, 14.9-34.8 pmol/L vs. 12.9; IQR, 9.4-21.6 pmol/L; P < 0.0001). Copeptin levels in 18 patients who died were more than two times greater as compared to patients who survived (32.4; IQR, 18.7-38.5 pmol/L vs. 15.1; IQR, 12.4-24.6 pmol/L; P < 0.0001). After adjusting for all other significant outcome predictors, copeptin level remained an independent predictor for poor functional outcome and mortality with an odds ratio of 3.12 (95 % CI 1.54-6.46), 3.16 (95 % CI 0.92-6.15), respectively. Our study suggests that copeptin levels are a useful tool to predict outcome and mortality 3 months after acute ischemic stroke and have a potential to assist clinicians.

Neuroendocrine hormones as prognostic biomarkers in the setting of acute stroke: overcoming the major hurdles

“…Another study was identified in the hand-searching. From the selected articles, three studies recruited patients with intracerebral hemorrhage [87,92,93], one with subarachnoid hemorrhage [88] and the other seven articles included ischemic stroke patients [85,86,89,[94][95][96][97].…”

Hyponatremia Is an Independent Predictor of In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage

“…29 Potentially supporting this association in ICH, previous studies on the neurohormone copeptin, the C-terminal portion of provasopressin, which is cosecreted with AVP from the hypothalamus, 30 report that increased copeptin was a marker of poorer outcome, which was shown in subarachnoid hemorrhage, ischemic stroke, and also in patients with ICH. [31][32][33] Despite these hypothetical pathophysiological considerations of hyponatremia-mediated effects on outcome, it remains unresolved whether hyponatremia simply represents a bystander of disease, that is, preexisting comorbidity or polymedication reflecting poorer overall status, which itself may be responsible for worse outcome. This aspect is even more important in light of the findings presented here, because all hyponatremia patients presented with hyponatremia on hospital admission rather than developed it during clinical course.…”

The Link between Early Biomarker Analysis and the Neurological Outcome in Stroke Patients

“…Four studies measured the outcome at three months, but could not confirm a link with the prognosis in their own analyses [21][22][23][24]. In the studies that did reach significance, two measured the outcome at three months, one at discharge and one at 48 h [16,18,24,25].…”