Balling Louise, Gustafsson Finn
Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Biomark Med. 2014;8(6):841-54. doi: 10.2217/bmm.14.50.
Increased neurohormonal activation is a key feature of heart failure (HF). Copeptin is a surrogate marker for proarginine vasopressin and the prognostic value of copeptin has been reported for multiple disease states of both nonvascular and cardiovascular etiology. Elevated plasma copeptin in HF has been associated with adverse outcomes such as increased mortality, risk of hospitalization and correlates with the severity of HF. Copeptin may add prognostic information to already established predictors such as clinical variables and natriuretic peptides in HF. In addition, copeptin has been found to be a superior marker when compared with BNP and NT-proBNP in HF patients discharged after hospitalization caused by HF or myocardial infarction (MI). The optimal use of copeptin in HF remains unresolved and future appropriately sized and randomized trials must determine the role of copeptin in HF as a marker of adverse outcomes, risk stratification or as a target in biomarker-guided therapy with arginine vasopressin-antagonists in individualized patient treatment and everyday clinical practice.
神经激素激活增加是心力衰竭（HF）的一个关键特征。 copeptin是精氨酸加压素的替代标志物，copeptin在多种非血管性和心血管病因的疾病状态中的预后价值已有报道。 HF患者血浆copeptin升高与不良预后相关，如死亡率增加、住院风险增加，并与HF的严重程度相关。 Copeptin可能会为HF中已有的预测指标（如临床变量和利钠肽）增加预后信息。此外，在因HF或心肌梗死（MI）住院后出院的HF患者中，copeptin被发现是比BNP和NT-proBNP更好的标志物。 copeptin在HF中的最佳应用仍未解决，未来适当规模的随机试验必须确定copeptin在HF中作为不良预后标志物、风险分层标志物或作为精氨酸加压素拮抗剂生物标志物导向治疗靶点在个体化患者治疗和日常临床实践中的作用。
