open access

Vol 29, No 4 (2022)
Original Article
Submitted: 2022-04-08
Accepted: 2022-04-20
Published online: 2022-05-24
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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

Natasza Blek12, Piotr Szwed3, Paulina Putowska3, Adrianna Nowicka4, Wiktoria L. Drela4, Aleksandra Gasecka3, Jerzy R. Ladny5, Yaroslaw Merza6, Milosz J. Jaguszewski7, Lukasz Szarpak8910
DOI: 10.5603/CJ.a2022.0045
·
Pubmed: 35621091
·
Cardiol J 2022;29(4):610-618.
Affiliations
  1. Institute of Clinical Science, Maria Sklodowska-Curie Medical A cademy, Warsaw, Poland, Warsaw, Poland
  2. Department of Neurology, Wolski Hospital, Warsaw, Poland, Warsaw, Poland
  3. Chair and Department of Cardiology, Medical University of Warsaw, Poland
  4. Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  5. Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
  6. Odesa National Medical University, Kyiv, Ukraine
  7. First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
  8. Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  9. Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
  10. Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland

open access

Vol 29, No 4 (2022)
Original articles — Clinical cardiology
Submitted: 2022-04-08
Accepted: 2022-04-20
Published online: 2022-05-24

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.

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Keywords

copeptin, C-terminal (pre)pro-vasopressin, prognostic biomarker, acute ischemic stroke, systematic review, meta-analysis

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Title

The diagnostic and prognostic value of copeptin in patients with acute ischemic stroke and transient ischemic attack: A systematic review and meta-analysis

Journal

Cardiology Journal

Issue

Vol 29, No 4 (2022)

Article type

Original Article

Pages

610-618

Published online

2022-05-24

Page views

1917

Article views/downloads

472

DOI

10.5603/CJ.a2022.0045

Pubmed

35621091

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

References (42)
  1. Feigin VL, Stark BA, Johnson CO, et al. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021; 20(10): 795–820.
  2. De Marchis GM, Weck A, Audebert H, et al. Copeptin for the prediction of recurrent cerebrovascular events after transient ischemic attack: results from the CoRisk study. Stroke. 2014; 45(10): 2918–2923.
  3. Montellano FA, Ungethüm K, Ramiro L, et al. Role of blood-based biomarkers in ischemic stroke prognosis: a systematic review. Stroke. 2021; 52(2): 543–551.
  4. Coutts SB. Diagnosis and management of transient ischemic attack. Continuum (Minneap Minn). 2017; 23(1, Cerebrovascular Disease): 82–92.
  5. Tang WZ, Wang XB, Li HT, et al. Serum copeptin predicts severity and recurrent stroke in ischemic stroke patients. Neurotox Res. 2017; 32(3): 420–425.
  6. Frank E, Landgraf R. The vasopressin system--from antidiuresis to psychopathology. Eur J Pharmacol. 2008; 583(2-3): 226–242.
  7. Katan M, Morgenthaler N, Widmer I, et al. Copeptin, a stable peptide derived from the vasopressin precursor, correlates with the individual stress level. Neuro Endocrinol Lett. 2008; 29(3): 341–346.
  8. Morgenthaler NG, Struck J, Alonso C, et al. Assay for the measurement of copeptin, a stable peptide derived from the precursor of vasopressin. Clin Chem. 2006; 52(1): 112–119.
  9. Zhong Y, Wang R, Yan L, et al. Copeptin in heart failure: review and meta-analysis. Clin Chim Acta. 2017; 475: 36–43.
  10. Yalta K, Yalta T, Sivri N, et al. Copeptin and cardiovascular disease: a review of a novel neurohormone. Int J Cardiol. 2013; 167(5): 1750–1759.
  11. Fenske W, Refardt J, Chifu I, et al. A copeptin-based approach in the diagnosis of diabetes insipidus. N Engl J Med. 2018; 379(5): 428–439.
  12. Winzeler B, Christ-Crain M. Use of coetin in the diagnosis of olyuria-olydisia syndrome - Authors’ reply. Lancet (London, England). 2020; 395: 267–268.
  13. Koseoglu M, Ozben S, Gozubatik-Celik G, et al. Plasma copeptin levels in patients with multiple sclerosis. J Clin Neurosci. 2020; 78: 143–146.
  14. Gomes DA, de Almeida Beltrão RL, de Oliveira Junior FM, et al. Vasopressin and copeptin release during sepsis and septic shock. Peptides. 2021; 136: 170437.
  15. Bellos I, Pergialiotis V, Papapanagiotou A, et al. Association between serum copeptin levels and preeclampsia risk: A meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2020; 250: 66–73.
  16. Wang CW, Wang JL, Zhang Yi, et al. Plasma levels of copeptin predict 1-year mortality in patients with acute ischemic stroke. Neuroreport. 2014; 25(18): 1447–1452.
  17. Katan M, Moon YP, Paik MC, et al. Procalcitonin and midregional proatrial natriuretic peptide as markers of ischemic stroke: The Northern Manhattan study. Stroke. 2016; 47(7): 1714–1719.
  18. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Int J Surg. 2021; 88: 105906.
  19. Sterne JAc, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016; 355: i4919.
  20. McGuinness LA, Higgins JPT. Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments. Res Synth Methods. 2021; 12(1): 55–61.
  21. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005; 5: 13.
  22. Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019; 10: ED000142.
  23. Wendt M, Ebinger M, Kunz A, et al. Copeptin levels in patients with acute ischemic stroke and stroke mimics. Stroke. 2015; 46(9): 2426–2431.
  24. De Marchis GM, Katan M, Weck A, et al. Copeptin adds prognostic information after ischemic stroke: results from the CoRisk study. Neurology. 2013; 80(14): 1278–1286.
  25. Deboevere N, Marjanovic N, Sierecki M, et al. Value of copeptin and the S-100b protein assay in ruling out the diagnosis of stroke-induced dizziness pattern in emergency departments. Scand J Trauma Resusc Emerg Med. 2019; 27(1): 72.
  26. Dong X, Tao DB, Wang YX, et al. Plasma copeptin levels in Chinese patients with acute ischemic stroke: a preliminary study. Neurol Sci. 2013; 34(9): 1591–1595.
  27. Katan M, Fluri F, Morgenthaler NG, et al. Copeptin: a novel, independent prognostic marker in patients with ischemic stroke. Ann Neurol. 2009; 66(6): 799–808.
  28. Katan M, Nigro N, Fluri F, et al. Stress hormones predict cerebrovascular re-events after transient ischemic attacks. Neurology. 2011; 76(6): 563–566.
  29. Perovic E, Mrdjen A, Harapin M, et al. Diagnostic and prognostic role of resistin and copeptin in acute ischemic stroke. Top Stroke Rehabil. 2017; 24(8): 614–618.
  30. Sun H, Huang D, Wang H, et al. Association between serum copeptin and stroke in rural areas of Northern China: a matched case-control study. Dis Markers. 2018; 2018: 9316162.
  31. Tu WJ, Dong X, Zhao SJ, et al. Prognostic value of plasma neuroendocrine biomarkers in patients with acute ischaemic stroke. J Neuroendocrinol. 2013; 25(9): 771–778.
  32. Urwyler SA, Schuetz P, Fluri F, et al. Prognostic value of copeptin: one-year outcome in patients with acute stroke. Stroke. 2010; 41(7): 1564–1567.
  33. von Recum J, Searle J, Slagman A, et al. Copeptin: limited usefulness in early stroke differentiation? Stroke Res Treat. 2015; 2015: 768401.
  34. Wang CB, Zong M, Lu SQ, et al. Plasma copeptin and functional outcome in patients with ischemic stroke and type 2 diabetes. J Diabetes Complications. 2016; 30(8): 1532–1536.
  35. Zhang JL, Yin CH, Zhang Y, et al. Plasma copeptin and long-term outcomes in acute ischemic stroke. Acta Neurol Scand. 2013; 128(6): 372–380.
  36. Choi KS, Kim HJ, Chun HJ, et al. Prognostic role of copeptin after stroke: a systematic review and meta-analysis of observational studies. Sci Rep. 2015; 5: 11665.
  37. Baranowska B, Kochanowski J. Copeptin: a new diagnostic and prognostic biomarker in neurological and cardiovascular diseases. Neuro Endocrinol Lett. 2019; 40(5): 207–214.
  38. Oraby M, Soliman R, Elkareem RA, et al. Copeptin: a potential blood biomarker for acute ischemic stroke. Egypt J Neurol Psychiatry Neurosurg. 2021; 57(1).
  39. Liamis G, Barkas F, Megapanou E, et al. Hyponatremia in acute stroke patients: pathophysiology, clinical significance, and management options. Eur Neurol. 2019; 82(1-3): 32–40.
  40. Spagnolello O, De Michele M, Lorenzano S, et al. Copeptin kinetics in acute ischemic stroke may differ according to revascularization strategies: pilot data. Stroke. 2019; 50(12): 3632–3635.
  41. Purroy F, Suárez-Luis I, Cambray S, et al. The determination of copeptin levels helps management decisions among transient ischaemic attack patients. Acta Neurol Scand. 2016; 134(2): 140–147.
  42. Sailer CO, Refardt J, Blum CA, et al. Validity of different copeptin assays in the differential diagnosis of the polyuria-polydipsia syndrome. Sci Rep. 2021; 11(1): 10104.

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