Value of Copeptin Measurement as A Novel Biomarker for Prognosis in Acute Heart Failure

Abstract

Abstract Background Copeptin, C-terminal segment of pro-arginine vasopressin, is expected to be a strong novel biomarker for prognosis in acute heart failure (AHF). Aim Evaluate the prognostic role of copeptin in AHF either de novo or on top of chronic heart failure and its correlation with adverse cardiac events. Methods The study included 45 patients with acute decompensated heart failure (ADHF) to assess the relationship of serum copeptin level on admission and 72 hours after admission with adverse cardiac events (death, re-hospitalization and arrhythmias) in patients hospitalized with ADHF between May 2019 and November 2019 with median follow up period 6 months. Results In this study, 15 patients died, re-admission for heart failure occurred in 22 patients and arrhythmias were documented in 14 patients with atrial fibrillation (n = 9) and ventricular arrhythmias (n = 5). Mortality rate was higher among the elderly, smokers and patients with higher heart rate, lower left ventricular ejection fraction, more frequent arrhythmias, impaired kidney function and higher copeptin level. Furthermore, copeptin level at day 1 with cutoff value of > 2.54 pmol/l predicted mortality with sensitivity of 86.67% and specificity of 53.33% while at day 3 copeptin level with cutoff value > 2.74 pmol/l predicted mortality with sensitivity of 93.33% and specificity of 83.33%. Finally, change in copeptin level between day 1 and day 3 was associated with increased mortality. (p<0.001) Conclusion Serum copeptin is suggested to be a strong biomarker to predict adverse clinical outcomes in patients with acute decompensated heart failure.