Copeptin, a fragment of the vasopressin precursor, as a novel predictor of outcome in heart failure

Background Natriuretic peptides, particularly brain natriuretic peptide (BNP), are elevated in heart failure and therefore considered to be excellent predictors of outcome. Vasopressin is also known to be related to the severity of heart disease. Copeptin – an inactive fragment of the vasopressin precursor – has not been previously investigated in the context of heart failure. Materials and methods We prospectively studied 268 patients with advanced heart failure after they had been discharged from the hospital. We investigated the ability of BNP and copeptin to predict death, re‐hospitalization due to heart failure, and a combination of the two endpoints. Results Over a mean follow‐up period of 15·8 months (up to 24 months), 83 patients died, 122 patients experienced worsening of heart failure, and 145 patients achieved the combined endpoint. Univariate predictors of death were copeptin, BNP, age and impaired kidney function. In multivariate analysis, copeptin (χ2 = 16, P