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The diagnostic and prognostic value of copeptin in patients with acute ischemic stroke and transient ischemic attack: A systematic review and meta-analysis
, 3, 3, 4, 4, 3, 5, 6, 7, 8910
Affiliations- Institute of Clinical Science, Maria Sklodowska-Curie Medical A cademy, Warsaw, Poland, Warsaw, Poland
- Department of Neurology, Wolski Hospital, Warsaw, Poland, Warsaw, Poland
- Chair and Department of Cardiology, Medical University of Warsaw, Poland
- Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
- Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
- Odesa National Medical University, Kyiv, Ukraine
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
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Abstract
Background: Stroke is the second main cause of mortality and the third leading cause of mortality and permanent disability combined. Many potential biomarkers have been described to contribute to the diagnosis, prognosis of outcomes, and risk stratification after stroke. Copeptin is an inactive peptide that is produced in an equimolar ratio to arginine vasopressin (AVP) in response to the activation of the endogenous stress system. Methods: The present study isa systematic review and meta-analysis to assess plasma copeptin concentrations, diagnostic and prognostic values for risk stratification after acute ischemic stroke and transient ischemic attack. Results: Mean copeptin level in stroke vs. non-stroke groups varied and amounted to 19.8 ± 17.4 vs. 9.7 ± 6.6 pmol/L, respectively (mean differences [MD]: 12.75; 95% confidence interval [CI]: 5.00 to 20.49; p < 0.001), in good vs. poor outcome 12.0 ± 3.6 vs. 29.4 ± 14.5 (MD: −8.13; 95% CI: −8.37 to −7.88; p < 0.001) and in survive vs. non-survive stroke patients: 13.4 ± 3.2 vs. 33.0 ± 12.3, respectively (MD: −13.43; 95% CI: −17.82 to −9.05; p < 0.001). Conclusions: The above systematic review and meta-analysis suggests that monitoring the copeptin levels may help predict the long-term prognosis of ischemic stroke efficiently. Determining the copeptin level may help individualize the management of ischemic stroke patients, keep stroke risk lower, reduce post-stroke complications, including patient death, and minimize healthcare costs.
Abstract
Background: Stroke is the second main cause of mortality and the third leading cause of mortality and permanent disability combined. Many potential biomarkers have been described to contribute to the diagnosis, prognosis of outcomes, and risk stratification after stroke. Copeptin is an inactive peptide that is produced in an equimolar ratio to arginine vasopressin (AVP) in response to the activation of the endogenous stress system. Methods: The present study isa systematic review and meta-analysis to assess plasma copeptin concentrations, diagnostic and prognostic values for risk stratification after acute ischemic stroke and transient ischemic attack. Results: Mean copeptin level in stroke vs. non-stroke groups varied and amounted to 19.8 ± 17.4 vs. 9.7 ± 6.6 pmol/L, respectively (mean differences [MD]: 12.75; 95% confidence interval [CI]: 5.00 to 20.49; p < 0.001), in good vs. poor outcome 12.0 ± 3.6 vs. 29.4 ± 14.5 (MD: −8.13; 95% CI: −8.37 to −7.88; p < 0.001) and in survive vs. non-survive stroke patients: 13.4 ± 3.2 vs. 33.0 ± 12.3, respectively (MD: −13.43; 95% CI: −17.82 to −9.05; p < 0.001). Conclusions: The above systematic review and meta-analysis suggests that monitoring the copeptin levels may help predict the long-term prognosis of ischemic stroke efficiently. Determining the copeptin level may help individualize the management of ischemic stroke patients, keep stroke risk lower, reduce post-stroke complications, including patient death, and minimize healthcare costs.
Keywords
copeptin, C-terminal (pre)pro-vasopressin, prognostic biomarker, acute ischemic stroke, systematic review, meta-analysis
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About this articleTitle
The diagnostic and prognostic value of copeptin in patients with acute ischemic stroke and transient ischemic attack: A systematic review and meta-analysis
Journal
Issue
Article type
Original Article
Pages
610-618
Published online
2022-05-24
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4618
Article views/downloads
808
DOI
Pubmed
Bibliographic record
Cardiol J 2022;29(4):610-618.
Keywords
copeptin
C-terminal (pre)pro-vasopressin
prognostic biomarker
acute ischemic stroke
systematic review
meta-analysis
Authors
Natasza Blek
Piotr Szwed
Paulina Putowska
Adrianna Nowicka
Wiktoria L. Drela
Aleksandra Gasecka
Jerzy R. Ladny
Yaroslaw Merza
Milosz J. Jaguszewski
Lukasz Szarpak
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