Department of Cardiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, 311800, China.
Ir J Med Sci. 2023 Oct;192(5):2129-2141. doi: 10.1007/s11845-023-03276-y. Epub 2023 Jan 31.
Copeptin, the C-terminal portion of provasopressin, has been regarded as a marker of non-specific stress response and a potentially prognostic biomarker of cardiovascular diseases. This systematic review and meta-analysis was conducted to summarize the predictive role of baseline copeptin for the prognosis of patients with coronary artery disease (CAD).
Relevant observational studies with longitudinal follow-up were obtained by comprehensive search of PubMed, Embase, and Web of Science databases. A random-effects model was used to pool the results.
Twenty-two studies with 19,821 patients with CAD were enrolled. Results of the meta-analyses revealed that a high copeptin at baseline was associated with a higher mortality risk (risk ratio [RR]: 1.76, 95% confidence interval [CI]: 1.49 to 2.09, p < 0.001; I = 70%) and an increased incidence of major adverse cardiovascular events (MACEs, RR: 1.49, 95% CI: 1.34 to 1.65, p < 0.001; I = 28%) in patients with CAD. Further results of sensitivity and subgroup analyses showed consistent associations between high copeptin with increased risks of mortality and MACEs in studies of patients with different ages, proportion of men, subtypes of CAD, study design, follow-up durations, and quality scores (p for subgroup effect all < 0.05).
A high plasma level of copeptin is associated with higher risks of mortality and MACEs in patients with CAD. Measuring copeptin may be helpful for risk stratification in patients with CAD.
加压素原 C 端片段 copeptin 被认为是一种非特异性应激反应标志物，也是心血管疾病潜在的预后生物标志物。本系统评价和荟萃分析旨在总结基线 copeptin 对冠状动脉疾病 (CAD) 患者预后的预测作用。
通过全面检索 PubMed、Embase 和 Web of Science 数据库，获得了具有纵向随访的相关观察性研究。使用随机效应模型汇总结果。
共纳入 22 项研究，共计 19821 例 CAD 患者。荟萃分析结果显示，基线高 copeptin 与更高的死亡率风险相关（风险比 [RR]：1.76，95%置信区间 [CI]：1.49 至 2.09，p<0.001；I=70%）和更高的主要不良心血管事件 (MACE) 发生率（RR：1.49，95%CI：1.34 至 1.65，p<0.001；I=28%）。敏感性和亚组分析的进一步结果表明，在不同年龄、男性比例、CAD 亚型、研究设计、随访时间和质量评分的研究中，高 copeptin 与死亡率和 MACE 风险增加之间均存在一致关联（亚组效应 p 值均<0.05）。
CAD 患者血浆 copeptin 水平升高与死亡率和 MACE 风险增加相关。测量 copeptin 可能有助于 CAD 患者的风险分层。
