Plasma levels of copeptin predict 1-year mortality in patients with acute ischemic stroke

Abstract

To evaluate the association between plasma levels of copeptin and 1-year mortality in a cohort of Chinese patients with acute ischemic stroke. We prospectively studied 275 patients with ischemic stroke who were admitted within 24 h after the onset of symptoms. Copeptin and NIH stroke scale (NIHSS) score were measured at the time of admission. The prognostic value of copeptin to predict mortality within 1 year was compared with the NIHSS score and other known outcome predictors. Nonsurvivors had significantly higher copeptin levels on admission compared with survivors (P<0.0001). Multivariate logistic regression analysis showed that elevated plasma levels of copeptin were an independent stroke mortality predictor, with an adjusted odds ratio of 4.48 [95% confidence interval (CI), 2.18-9.06]. The area under the receiver operating characteristic curve of copeptin was 0.882 (95% CI, 0.847-0.921) for stroke mortality, which yielded a sensitivity of 90.7% and a specificity of 84.5%. Copeptin improved the NIHSS score (area under the curve of the combined model, 0.94; 95% CI, 0.91-0.97; P=0.011). Elevated plasma copeptin levels at admission were an independent predictor of long-term mortality after ischemic stroke in a Chinese sample, suggesting that these alterations might play a role in the pathophysiology of stroke.

Biomarkers for prognostic functional recovery poststroke: A narrative review

“…In stroke, vasopressin release is driven by cerebral edema, volume overload, and hyponatremia, and copeptin increases in bacterial infections and febrile conditions ( Zhang et al, 2013 ). Hypoxemia can lead to abnormal renal water excretion, which is most likely mediated via vasopressin release ( Zhang et al, 2013 ; Wang C.-W. et al, 2014 ).…”

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

“…Some articles did not meet the inclusion criteria; on this basis, 31 full-text papers with insufficient data for extraction were excluded. After screening for all the probable factors, 5057 patients were finally included from 17 studies [ 2 , 5 , 16 , 17 , 23 – 35 ].…”

“…Table 1 summarizes the 17 articles included in the systemic review and their methodologies. All studies were conducted between 2009 and 2019 in China [ 5 , 16 , 26 , 30 , 31 , 34 , 35 ], Switzerland [ 17 , 27 , 28 , 32 ], Germany [ 23 , 33 ], Switzerland and Germany [ 2 , 24 ], France [ 25 ], and Croatia [ 29 ]. The risk of bias of these studies was low (n = 14) or moderate (n = 3) ( Suppl.…”

“…A flowchart of the publication selection process is presented in Figure 1. The database search- After screening for all the probable factors, 5057 patients were finally included from 17 studies [2,5,16,17,[23][24][25][26][27][28][29][30][31][32][33][34][35]. Table 1 summarizes the 17 articles included in the systemic review and their methodologies.…”

“…It was also described to have clinical implications in non-cardiovascular diseases such as polydipsia-polyuria syndrome, multiple sclero-sis, sepsis, or preeclampsia [11][12][13][14][15]. Due to the positive relationship of increases in the copeptin level in patients with acute ischemic stroke and TIA, it is assumed that copeptin is a good marker for differential diagnosis between stroke, TIA, and stroke-mimics diseases [16]. Moreover, an elevated copeptin concentration was related to worse prognosis in patients after stroke and to a higher incidence of recurrent TIA or stroke after a TIA event [2].…”