Plasma Copeptin Level In Patients Research Articles

The Diagnostic Value of Plasma Copeptin Level in Patients with Acute Appendicitis.

This study aims to determine the effectiveness of plasma copeptin level, leukocyte, and neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of patients with acute appendicitis presenting to the emergency department. Patients over the age of 18 presenting to the emergency department due to abdominal pain and diagnosed with acute appendicitis as a result of clinical, laboratory, and radiological evaluation were included in the study. The control group consisted of healthy volunteers. Blood samples were taken from all groups at the time of admission. Plasma copeptin level was studied using the ELISA kit. Statistical Package for the Social Sciences v.22 (IBM SPSS Statistics for Windows; IBM Corp., Armonk, NY, USA) was used for statistical analysis. Fifty patients and 50 healthy volunteers were included in the study. Plasma copeptin, leukocytes, and NLR levels were found to be significantly higher in the appendicitis group compared to the control group. In receiver operating characteristic curve (ROC) analysis, copeptin had 96% sensitivity and 92% specificity at the optimal cutoff value of 3.2 ng/mL to predict patients with appendicitis [area under the curve (AUC): 0.994, 95% confidence interval (CI): 0.984 - 1, p < 0.0001)]. In this study, plasma copeptin levels, leukocytes, and NLR were found to be significantly higher in AA patients compared to healthy volunteers. Increased plasma copeptin level in AA patients may play a potential role in the diagnosis of appendicitis.

Plasma copeptin levels in patients with multiple sclerosis

We compared copeptin levels in relapsing-remitting multiple sclerosis (RRMS) patients with controls and investigated how plasma copeptin levels were changed with the disease period.Thirty patients with RRMS without a prior attack in the last twelve months, and 19 RRMS patients with a clinical acute attack and 30 healthy individuals were included into the study.Copeptin levels were significantly higher in all RRMS patient groups than healthy controls. Plasma copeptin levels were higher in patients in remission period compared with relapse period of 19 RRMS patients with an acute attack.We consider copeptin can be used as a potential biomarker for RRMS.

Effects of the prophylactic use of escitalopram on the prognosis and the plasma copeptin level in patients with acute cerebral infarction.

This study aimed to investigate whether the routine administration of escitalopram for three months would improve the prognosis of patients with ischemic stroke and decrease the plasma copeptin level. A total of 97 patients with acute cerebral infarction were randomly allocated to receive escitalopram (5-10 mg once per day, orally; n=49) or not to receive escitalopram (control group; n=48) for 12 weeks starting at 2-7 days after the onset of stroke. Both groups received conventional treatments, including physiotherapy and secondary prevention of stroke. The National Institutes of Health Stroke Scale (NIHSS) score was used to evaluate the disability of patients at the initial evaluation and at the monthly follow-up visits for three months. Impairment in the daily activities was assessed using the Barthel Index (BI), while cognitive impairment was assessed using Mini-Mental State Examination (MMSE) score. The psychiatric assessment included the administration of the Present State Examination modified to identify Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptoms of depression. The severity of depression was measured using the 17-item Hamilton Rating Scale for Depression (HAMD). During the 3-month follow-up period, 95 patients were included in the analysis (two patients withdrew from the escitalopram group). NIHSS and BI improvement at the 90th day were significantly greater in the escitalopram group (P<0.05), while HAMD and plasma copeptin levels significantly decreased, compared to the control group (P<0.01). In patients with acute ischemic stroke, the earlier administration of escitalopram for three months may improve neurological functional prognosis and decrease copeptin level.

Plasma copeptin levels in patients with restless legs syndrome.

Copeptin, the C-terminal fragment of antidiuretic hormone, is a new biomarker that has been found to be elevated in several disorders and could be related with prognosis. This study aimed to compare plasma copeptin levels in patients with restless legs syndrome (RLS) with healthy individuals and to investigate whether plasma copeptin levels were associated with the severity of disease. 41 patients with primary RLS, who were followed in Bakirkoy Psychiatry and Neurology Research and Training Hospital and 41 age- and sex-matched healthy individuals were included into the study. RLS patients were divided into subgroups as mild-moderate, severe, and very severe according to the severity of symptoms. Sleep quality and excessive daytime sleepiness were determined according to Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale, respectively, and sleep quality scores were analyzed statistically among the groups divided according to disease severity. Copeptin levels in all the patients were compared to the controls. RLS subgroups were compared with each other to evaluate association between copeptin levels and disease severity. Plasma copeptin levels in RLS patients were significantly higher than controls (P<.001). However, there was no association between copeptin levels and disease severity. Excessive daytime sleepiness was found as 14.63% and low sleep quality as 68.29% in patients. Hypothalamic-pituitary-adrenal axis activation and sympathetic hyperactivity in RLS might be responsible for increased Antidiuretic hormone (ADH) and copeptin release. We think that copeptin might have a potential role in the pathogenesis of RLS and be a biomarker for this disease.

Plasma copeptin and functional outcome in patients with ischemic stroke and type 2 diabetes

BackgroundThe activation of the arginine vasopressin system may be involved in the pathology of stroke and diabetes. In this study, we therefore evaluated the short-term prognostic value of early measurement of plasma copeptin levels in Chinese patients with type 2 diabetes mellitus (T2DM) and acute ischemic stroke (AIS). MethodsFrom July 2014 to June 2015, all T2DM patients with first-ever AIS were included. Plasma levels of copeptin were tested at admission. The prognostic value of copeptin to predict the functional outcome and mortality 3months after stroke was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors. ResultsWe recorded 247 stroke patients with T2DM. The copeptin levels were obtained in those patients with a median value of 14.3pmol/L (IQR, 9.5–17.1pmol/L). At 3-month follow-up, a favorable functional outcome was found in 86 patients (34.8%). Plasma copeptin levels in patients with an unfavorable outcome were significantly greater than those in patients with a favorable outcome (16.2 [IQR, 12.2–20.3] vs. 12.4 [IQR, 8.6–15.2] pmol/L; Z=5.399; P<0.0001). In univariate logistic regression analysis, with an unadjusted OR of 1.123 (95% CI, 1.072–1.177, P<0.001), copeptin had a strong association with unfavorable functional outcome. In multivariate analyses, a copeptin level in the highest inter-quartile (>17.1pmol/L) was associated with a higher risk of unfavorable functional outcome (OR=4.62; 95% CI=2.63–9.21; P<0.001). After adjusting for other outcome predictors, a copeptin level in the highest inter-quartile (>17.1pmol/L) was associated with a higher risk of mortality (OR=5.12; 95% CI=2.20–11.38; P<0.001). ConclusionOur study suggested that copeptin levels may reliably predict short-term stroke prognosis at its onset in Chinese patients with T2DM and stroke.

Differential Regulation of Plasma Copeptin Levels in Patients with Heart Failure: A Single-Center Prospective Study

Elevated levels of arginine vasopressin (AVP) have been reported to be involved in the pathogenesis of heart failure (HF). Recent evidence has shown the role of copeptin, the C-terminal fragment of pro-AVP, as a biomarker in patients with HF. However, the relevant information is still limited. Therefore, we evaluated 39 Japanese patients admitted for HF between 2013 and 2015 (23 males and 16 females with an average age of 79.2 years). They were treated according to the Japanese acute HF guideline. Plasma copeptin levels were measured on admission and about 1 week later. The median plasma copeptin levels on admission were 0.5 (0.1-50.6) pmol/L, higher than the normal values (0.24 ± 0.06 pmol/L). Despite the similar clinical severity on admission, the patients showed great variability in plasma copeptin levels. They were divided into three groups (13 patients/group) according to plasma copeptin levels on admission: highest (> 30.8 pmol/L), midrange, and lowest (< 0.2 pmol/L) groups. Initial treatment improved HF symptoms in 37 of 39 patients, with the two unresponsive patients in the lowest group. Notably, plasma copeptin responses to initial treatment were different, depending on admission copeptin levels. The initial treatment significantly decreased copeptin levels in the highest group, but increased copeptin levels in the lowest group. By contrast, patients in the midrange group showed no significant changes. Thus, the treatment appears to restore the plasma copeptin levels. In conclusion, HF is a complex syndrome with the differential integration of stimulatory and inhibitory inputs to the AVP/copeptin secretory system.

Prognostic value of copeptin: One-year outcome in patients with traumatic brain injury

High plasma copeptin level has been associated with one-month mortality after traumatic brain injury. However, not much is known regarding its relation with long-term outcome. Thus, we investigated the ability of copeptin to predict 1-year outcome in patients with traumatic brain injury. One hundred and six healthy controls and 106 patients with acute severe traumatic brain injury were included. Plasma samples were obtained on admission. Its concentration was measured by enzyme-linked immunosorbent assay. Forty-eight patients (45.3%) suffered from unfavorable outcome (Glasgow Outcome Scale score of 1–3) and 31 patients (29.2%) died in 1 year after traumatic brain injury. Upon admission, plasma copeptin level in patients was substantially higher than that in healthy controls. A forward stepwise logistic regression selected plasma copeptin level as an independent predictor for 1-year unfavorable outcome and mortality of patients. A receiver operating characteristic curve analysis showed plasma copeptin level predicted 1-year unfavorable outcome and mortality obviously. The predictive value of the copeptin concentration was thus similar to that of Glasgow Coma Scale score for the prediction of unfavorable outcome and mortality after 1 year. In a combined logistic-regression model, copeptin improved the area under curve of Glasgow Coma Scale score for the prediction of unfavorable outcome and mortality after 1 year, but the differences were not significant. Thus, copeptin level is a useful, complementary tool to predict functional outcome and mortality 1 year after traumatic brain injury.

Copeptin Is Associated With Mortality in Patients With Traumatic Brain Injury

High serum copeptin levels are associated with injury severity after traumatic brain injury (TBI). However, not much is known regarding its relation with mortality. Thus, we sought to evaluate its relation with disease mortality. Fifty healthy controls and 94 patients with acute severe TBI were included. Plasma samples were obtained on admission and at days 1, 2, 3, 5, and 7. Its concentration was measured by enzyme-linked immunosorbent assay. Twenty-six patients (27.7%) died from TBI in a month. After brain injury, plasma copeptin level in patients increased during the 6-hour period immediately, peaked in 24 hours, plateaued at day 2, decreased gradually thereafter, and was substantially higher than that in healthy controls during the 7-day period. A forward stepwise logistic regression selected plasma copeptin level (odds ratio, 1.008; 95% confidence interval, 1.002-1.014; p = 0.010) as an independent predictor for 1-month mortality of patients. A multivariate linear regression showed that plasma copeptin level was negatively associated with Glasgow Coma Scale (GCS) score (t = -7.161; p < 0.001). A receiver operating characteristic curve identified plasma copeptin cutoff level (451.8 pg/mL) that predicted 1-month mortality with the optimal sensitivity (88.5%) and specificity (75.0%) values (area under curve, 0.874; 95% confidence interval, 0.789-0.933; p < 0.001). The area under curve of plasma copeptin level was similar to that of GCS score (p = 0.299). However, copeptin did not statistically significantly improve the area under curve of GCS score (p = 0.413). Increased plasma copeptin levels are associated with mortality after TBI.

Detection of copeptin in peripheral blood of patients with aneurysmal subarachnoid hemorrhage

IntroductionCopeptin has been proposed as a prognostic marker in acute illness. This study investigated the ability of copeptin to predict the disease outcome and cerebrovasospasm in the patients with aneurysmal subarachnoid hemorrhage.MethodsIn this retrospective study, 303 consecutive patients were included. Upon admission, plasma copeptin levels were measured by enzyme-linked immunosorbent assay. The end points were mortality after 1 year, in-hospital mortality, cerebrovasospasm and poor functional outcome (Glasgow Outcome Scale score of 1-3) after 1 year.ResultsUpon admission, plasma copeptin level in patients was statistically significantly higher than that in healthy controls. A multivariate analysis showed that plasma copeptin level was an independent predictor of poor functional outcome and mortality after 1 year, in-hospital mortality and cerebrovasospasm. A receiver operating characteristic curve showed that plasma copeptin level on admission predicted poor functional outcome and mortality after 1 year, in-hospital mortality and cerebrovasospasm of patients statistically significantly. The area under curve of the copeptin concentration was similar to those of World Federation of Neurological Surgeons (WFNS) score and modified Fisher score for the prediction of poor functional outcome and mortality after 1 year, and in-hospital mortality, but not for the prediction of cerebrovasospasm. In a combined logistic-regression model, copeptin improved the area under curve of WFNS score and modified Fisher score for the prediction of poor functional outcome after 1 year, but not for the prediction of mortality after 1 year, in-hospital mortality, and cerebrovasospasm.ConclusionsCopeptin level is a useful, complementary tool to predict functional outcome and mortality after aneurysmal subarachnoid hemorrhage.

Change in plasma copeptin level after acute spontaneous basal ganglia hemorrhage

High plasma copeptin levels are associated with mortality after intracerebral hemorrhage (ICH). However, there is a paucity of data available on whether copeptin is an independent prognostic marker of mortality. Thus, we sought to furthermore evaluate this relation. Thirty healthy controls and 86 patients with acute ICH were included. Plasma samples were obtained on admission and at days 1, 2, 3, 5, and 7 after ICH. Its concentration was measured by enzyme-linked immunosorbent assay. After ICH, plasma copeptin level in patients increased during the 6-h period immediately, peaked in 24 h, decreased gradually thereafter, and was substantially higher than that in healthy controls during the 7-day period. A multivariate analysis showed plasma copeptin level was an independent predictor for 1-week mortality (odds ratio, 1.013; 95% confidence interval (CI), 1.003–1.023; P = 0.009) and positively associated with hematoma volume ( t = 6.616, P < 0.001). A receiver operating characteristic curve identified that a baseline plasma copeptin level >577.5 pg/mL predicted 1-week mortality with 87.5% sensitivity and 72.2% specificity (area under curve (AUC), 0.873; 95% CI, 0.784–0.935). The AUC of the copeptin concentration was similar to those of Glasgow Coma Scale (GCS) scores and hematoma volumes ( P = 0.136 and 0.280). However, copeptin did not statistically significantly improve the AUCs of GCS scores and hematoma volumes ( P = 0.206 and 0.333). Hence, increased plasma copeptin level is associated with hematoma volume and an independent prognostic marker of mortality after ICH.

Determination of plasma copeptin level in patients with coronary heart disease and its diagnostic value for severity of coronary atherosclerosis

Objective:To determine the plasma level of copeptin in patients with coronary heart disease,and to discuss its diagnostic value for severity of coronary atherosclerosis.Methods:Coronary angiography (CAG) was performed in 180 hospitalized patients with suspected coronary heart disease (CHD).The 180 patients were divided into two groups:CHD group (n=101) and non-CHD group (control,n=79) based on the results of CAG.The CHD group was further divided into subgroups according to the number of diseased coronary branches and Gensini's score:one-vessel subgroup (38),two-vessel subgroup (34) and three-vessel subgroup (29),0Gensini's score20 subgroup (40),20≤Gensini's score40 subgroup (29) and Gensini's score≥40 subgroup (32).Plasma copeptin,lipids,fasting plasma glucose,blood pressure,and body mass index were measured before CAG in all patients; age,sex,and prior medical histories including hypertension,diabetes mellitus,and smoking status were also obtained.Plasma copeptin was determined by radioimmunoassay (RIA) and were compared between different groups.Results:Plasma copeptin level(ng/ml) in CHD patients was significantly higher than that in the controls (0.953 6±0.098 6 vs 0.924 4±0.064 9,P0.05).Plasma copeptin levels in two-vessel subgroup and three-vessel subgroup were significantly higher than those in the control and one-vessel subgroup (P0.05),with no significant difference found between the former two groups.Plasma copeptin levels in 20≤Gensini's score40 subgroup and Gensini's score≥40 subgroup were significantly higher than those in the control group and 0Gensini's score20 subgroup (P0.05),with no significant difference found between 20≤Gensini's score40 subgroup and Gensini's score≥40 subgroup.Conclusion:Plasma copeptin in CHD patients is at a higher level,and to some extent it can reflect the severity of coronary atherosclerosis,but has little value in identification of severe coronary heart diseases.