Ozmen Caglar, Deveci Onur Sinan, Tepe Omer, Yesildas Cuma, Ünal İlker, Yıldız İbrahim, Eker Akıllı Rabia, Deniz Ali, Demir Mesut, Kanadaşı Mehmet, Usal Ayhan
Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey.
Faculty of Medicine, Department of Cardiology, Mersin University, Mersin, Turkey.
Acta Cardiol. 2021 Oct;76(8):842-851. doi: 10.1080/00015385.2020.1786624. Epub 2020 Jul 15.
In heart failure (HF), various biomarkers have been established for prognosis. However, little is known about the relevance of copeptin measurements to HF. This study aimed to explore the prognostic value of copeptin for predicting cardiovascular (CV) death or HF-related re-hospitalisation in patients with acute decompensated HF.
We prospectively enrolled 155 consecutive patients with acute signs and symptoms of HF. Plasma copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured at admission. Patients were monitored for 90 days regarding the composite endpoint of CV death or acute HF-related re-hospitalisation.
Of the 155 patients enrolled, 40 reached the endpoint, and 115 were in a stable condition during follow-up. Patients who reached an adverse endpoint showed higher NT-proBNP and copeptin levels compared to patients in stable condition. Receiver operating characteristic curve analysis revealed that the area under curve of copeptin 0.844 (95% CI, 0.753-0.935) was superior to that of NT-proBNP 0.809 (95% CI, 0.729-0.890) for the prediction of adverse events within 90 days. Meanwhile, compared to the group with lower copeptin levels (<34 pmol/L), patients with higher copeptin levels (≥34 pmol/L) were at a 10.672-times higher risk of CV death or acute HF-related re-hospitalisation. Multivariate Cox proportional hazards regression analysis revealed that increased copeptin level was a significantly independent predictor of adverse events (risk ratio, 1.051; 95% CI, 1.020-1.083; < 0.001).
Copeptin was found to be a strong, novel marker for predicting CV death or HF-related re-hospitalisation in patients with acute decompensated HF.
在心力衰竭（HF）中，已确立多种生物标志物用于预后评估。然而，关于 copeptin 检测与 HF 的相关性知之甚少。本研究旨在探讨 copeptin 对急性失代偿性 HF 患者预测心血管（CV）死亡或 HF 相关再住院的预后价值。
我们前瞻性纳入了 155 例连续的有 HF 急性体征和症状的患者。入院时测定血浆 copeptin 和 N 末端 B 型利钠肽原（NT-proBNP）水平。对患者进行 90 天的监测，观察 CV 死亡或急性 HF 相关再住院的复合终点事件。
在纳入的 155 例患者中，40 例达到终点，115 例在随访期间病情稳定。与病情稳定的患者相比，达到不良终点的患者 NT-proBNP 和 copeptin 水平更高。受试者工作特征曲线分析显示，copeptin 的曲线下面积为 0.844（95%CI，0.753 - 0.935），在预测 90 天内不良事件方面优于 NT-proBNP 的曲线下面积 0.809（95%CI，0.729 - 0.890）。同时，与 copeptin 水平较低（<34 pmol/L）的组相比，copeptin 水平较高（≥34 pmol/L）的患者发生 CV 死亡或急性 HF 相关再住院的风险高 10.672 倍。多变量 Cox 比例风险回归分析显示，copeptin 水平升高是不良事件的显著独立预测因子（风险比，1.051；95%CI，1.020 - 1.083；P < 0.001）。
发现 copeptin 是预测急性失代偿性 HF 患者 CV 死亡或 HF 相关再住院的一种强大的新型标志物。
