Copeptin in heart failure: Review and meta-analysis

Abstract

BackgroundThe aim of this study was to explore the prognostic value of copeptin for predicting all-cause mortality in heart failure (HF). MethodsPubMed, Embase and Cochrane databases were systematically searched to identify if a 2×2 contingency table could be constructed based on both the copeptin level and the all-cause mortality in patients diagnosed with HF. The characteristics of test performance were summarized using forest plots and summary receiver operating characteristic curves (SROC). Q-test and I2 index were used to evaluate heterogeneity. ResultsTen prospective cohort studies comprising 4473 patients were eligible in this meta-analysis. An elevated copeptin level was associated with an increased risk of all-cause mortality in HF patients (Relative risk (RR) was 2.64 (95% CI, 2.09–3.32)). The pooled sensitivity (SEN) and specificity (SPE) of copeptin were 0.57 (95% CI, 0.50–0.63) and 0.74 (95% CI, 0.69–0.79), respectively. The positive likelihood ratio was 2.2 (95% CI, 1.90–2.60) and the negative likelihood ratio was 0.58 (95% CI, 0.52–0.66). Furthermore, the summary Diagnostic Odds Ratio (DOR) was 4.00 (95% CI, 3.00–5.00) and the AUC was 0.70 (95% CI, 0.66–0.74) similar to the AUC of NT-proBNP 0.71 (95% CI, 0.67–0.75). ConclusionsElevated levels of copeptin are associated with all-cause mortality in HF patients. The predictive value of copeptin is comparable with NT-proBNP for all-cause mortality in HF patients. Further studies are warranted to explore the prognostic value of copeptin in conjunction with other biomarkers and to determine an optimal cut-off level.