Abstract PR171

Abstract

Background & Objectives: The incidence of cognitive dysfunction (POCD) after carotid surgery is about 10–28%.1 The accumulating evidences show that microembolisation, hypoperfusion and the stress response induced by surgical stimuli might play an important role in the pathogenesis of POCD.2 Copeptin is the C-terminal fragment of provasopressin and is presumably co-secreted with arginine vasopressin from the hypothalamus. Copeptin concentrations in plasma increase as a response of physiological stress and have been shown to have prognostic value in several disease entities. The aim of our study was to investigate the ability of postoperative serum copeptin level to predict POCD in patients undergoing carotid endarterectomy (CEA). Materials & Methods: This prospective, nonrandomized study was conducted on patients operated for carotid stenosis during a 6-month period at a referral, high-volume vascular center. The Local Ethical Board approved the study. All patients underwent CEA under general anesthesia. Blood samples were drawn to determine the levels of copeptin 3 hours after the surgery. Neuropsychological evaluation was performed 1 day before and one day after surgery. In total, a battery of 10 neuropsychological tests was used that assessed a range of cognitive functions including attention, memory and executive function. Statistical analysis was performed with SPSS 20.0. Results: This study included 98 patients. This group of patients included 59 men and 39 women and had a mean age of 66.0 ± 6.8 years. 27 patients (27.6%) had POCD after carotid surgery. Serum copeptin concentration found to be as the independent predictor for POCD after surgery. A ROC curve analysis showed that a serum copeptin level >71.6 pmol/L predicted POCD after carotid surgery with 92.6% sensitivity and 67.7%. specificity (AUC 0.846; 95% IP, 0.766 - 0.925). Conclusion: In this study, it was found that copeptin has high predictive value for POCD after carotid surgery.