Zhang Peng, Wu Xiaomei, Li Guangxiao, Sun Hao, Shi Jingpu
Department of Clinical Epidemiology, Center of Evidence-Based Medicine, Institute of Cardiovascular Disease, The First Hospital of China Medical University, Shenyang, People's Republic of China.
Ther Clin Risk Manag. 2017 Jan 5;13:49-58. doi: 10.2147/TCRM.S124689. eCollection 2017.
As the C-terminal section of vasopressin precursor, copeptin has been recently suggested as a new prognostic biomarker after heart failure (HF). Thus, the aim of this study was to evaluate the prognostic value of plasma copeptin level with all-cause mortality in patients with HF.
Comprehensive strategies were used to search relevant studies from electronic databases. Pooled hazard ratios (HRs) and standardized mean differences (SMDs) together with their 95% confidence intervals (CIs) were calculated. Subgroup analysis and sensitivity analysis were performed to find the potential sources of heterogeneity.
A total of 5,989 participants from 17 prospective studies were included in this meta-analysis. A significant association was observed between circulating copeptin levels and risk of all-cause mortality in patients with HF (categorical copeptin: HR =1.69, 95% CI =1.42-2.01; per unit copeptin: HR =1.03, 95% CI =1.00-1.07; log unit copeptin: HR =3.26, 95% CI =0.95-11.25). Pooled SMD showed that copeptin levels were significantly higher in patients with HF who died during the follow-up period than in survivors (SMD =1.19, 95% CI =0.81-1.57). Subgroup analyses also confirmed this significant association, while sensitivity analyses indicated that the overall results were stable.
This study demonstrated that circulating copeptin seemed to be a novel biomarker to provide better prediction of all-cause mortality in patients with HF.
作为血管加压素前体的C末端部分， copeptin最近被认为是心力衰竭（HF）后一种新的预后生物标志物。因此，本研究的目的是评估血浆copeptin水平对HF患者全因死亡率的预后价值。
采用综合策略从电子数据库中检索相关研究。计算合并风险比（HRs）和标准化平均差（SMDs）及其95%置信区间（CIs）。进行亚组分析和敏感性分析以发现异质性的潜在来源。
本荟萃分析共纳入来自17项前瞻性研究的5989名参与者。观察到HF患者循环copeptin水平与全因死亡风险之间存在显著关联（分类copeptin：HR = 1.69，95% CI = 1.42 - 2.01；每单位copeptin：HR = 1.03，95% CI = 1.00 - 1.07；对数单位copeptin：HR = 3.26，95% CI = 0.95 - 11.25）。合并SMD显示，随访期间死亡的HF患者的copeptin水平显著高于幸存者（SMD = 1.19，95% CI = 0.81 - 1.57）。亚组分析也证实了这种显著关联，而敏感性分析表明总体结果是稳定的。
本研究表明，循环copeptin似乎是一种新的生物标志物，可更好地预测HF患者的全因死亡率。
