Clinical relevance of copeptin plasma levels as a biomarker of disease severity and mortality in critically ill patients.

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Clinical relevance of copeptin plasma levels as a biomarker of disease severity and mortality in critically ill patients.

J Clin Lab Anal. 2018 Jul 05;:e22614

Authors: Koch A, Yagmur E, Hoss A, Buendgens L, Herbers U, Weiskirchen R, Koek GH, Trautwein C, Tacke F

Abstract
BACKGROUND: Copeptin, also termed C-terminal pre-pro-vasopressin or CTproAVP, mirrors endogenous vasopressin (anti-diuretic hormone, ADH) activity and might thereby serve as a biomarker reflecting the biological stress level. We therefore hypothesized that copeptin plasma concentrations are associated with disease severity in critically ill patients and could predict mortality.
METHODS: We analyzed plasma copeptin levels in a prospective, single-center, observational study comprising 218 critically ill patients at admission to the medical intensive care unit (ICU). Mortality was assessed during a 2-year observational follow-up period.
RESULTS: Copeptin plasma levels were significantly elevated in critically ill patients (n = 218) at ICU admission, as compared with 66 healthy controls. Neither sepsis as the cause of critical illness nor pre-existing metabolic disorders (type 2 diabetes, obesity) were found to influence copeptin levels. On the contrary, plasma copeptin was closely associated with disease severity (eg APACHE-II score) and correlated with biomarkers of inflammation, renal failure, metabolism, vascular tone, and tissue perfusion. Elevated copeptin levels at ICU admission predicted short-term and long-term mortality.
CONCLUSIONS: Copeptin plasma concentrations are significantly elevated in critically ill patients, correlate with disease severity and predict ICU and long-term outcome. Thus, copeptin could be a promising tool for prognostication and management of critically ill patients.

PMID: 29974524 [PubMed - as supplied by publisher]

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