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 p...
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| Veröffentlicht in: | European journal of clinical investigation 2006-11, Vol.36 (11), p.771-778 |
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| container_title | European journal of clinical investigation |
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| creator | Stoiser, B. Mörtl, D. Hülsmann, M. Berger, R. Struck, J. Morgenthaler, N. G. Bergmann, A. Pacher, R. |
| description | 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 |
| doi_str_mv | 10.1111/j.1365-2362.2006.01724.x |
| format | Article |
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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 < 0·0001) and age (χ2 = 4, P < 0·05) were independent predictors. Univariate predictors of re‐hospitalization due to heart failure were copeptin, BNP, age and impaired kidney function. Furthermore, in multivariate analysis BNP (χ2 = 18, P < 0·0001), age (χ2 = 11·8, P < 0·001) and copeptin (χ2 = 4·2, P < 0·05) were found to be independent predictors.
Conclusion Our study is the first to show that copeptin is an excellent predictor of outcome in advanced heart failure patients. Its value is superior to that of BNP in predicting death and a combined endpoint, although BNP is still suitable for predicting chronic heart failure (CHF) re‐hospitalization. Our data imply that vasopressin antagonism might be a new target to improve outcome in this population.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/j.1365-2362.2006.01724.x</identifier><identifier>PMID: 17032344</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Biomarkers - blood ; Cardiology. Vascular system ; Chronic Disease ; Copeptin ; Female ; General aspects ; Glycopeptides - blood ; Heart ; heart failure ; Heart Failure - diagnosis ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Male ; Medical sciences ; Multivariate Analysis ; Natriuretic Peptide, Brain - blood ; natriuretic peptides ; Predictive Value of Tests ; prognosis ; Prospective Studies ; vasopressin</subject><ispartof>European journal of clinical investigation, 2006-11, Vol.36 (11), p.771-778</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5014-1d4c5ee71c3d62ebeafcef36b9e4d01f4e944bcb2fd2beb170262c9c5a5c34223</citedby><cites>FETCH-LOGICAL-c5014-1d4c5ee71c3d62ebeafcef36b9e4d01f4e944bcb2fd2beb170262c9c5a5c34223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2362.2006.01724.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2362.2006.01724.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18176319$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17032344$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stoiser, B.</creatorcontrib><creatorcontrib>Mörtl, D.</creatorcontrib><creatorcontrib>Hülsmann, M.</creatorcontrib><creatorcontrib>Berger, R.</creatorcontrib><creatorcontrib>Struck, J.</creatorcontrib><creatorcontrib>Morgenthaler, N. G.</creatorcontrib><creatorcontrib>Bergmann, A.</creatorcontrib><creatorcontrib>Pacher, R.</creatorcontrib><title>Copeptin, a fragment of the vasopressin precursor, as a novel predictor of outcome in heart failure</title><title>European journal of clinical investigation</title><addtitle>Eur J Clin Invest</addtitle><description>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 < 0·0001) and age (χ2 = 4, P < 0·05) were independent predictors. Univariate predictors of re‐hospitalization due to heart failure were copeptin, BNP, age and impaired kidney function. Furthermore, in multivariate analysis BNP (χ2 = 18, P < 0·0001), age (χ2 = 11·8, P < 0·001) and copeptin (χ2 = 4·2, P < 0·05) were found to be independent predictors.
Conclusion Our study is the first to show that copeptin is an excellent predictor of outcome in advanced heart failure patients. Its value is superior to that of BNP in predicting death and a combined endpoint, although BNP is still suitable for predicting chronic heart failure (CHF) re‐hospitalization. Our data imply that vasopressin antagonism might be a new target to improve outcome in this population.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cardiology. Vascular system</subject><subject>Chronic Disease</subject><subject>Copeptin</subject><subject>Female</subject><subject>General aspects</subject><subject>Glycopeptides - blood</subject><subject>Heart</subject><subject>heart failure</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Multivariate Analysis</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>natriuretic peptides</subject><subject>Predictive Value of Tests</subject><subject>prognosis</subject><subject>Prospective Studies</subject><subject>vasopressin</subject><issn>0014-2972</issn><issn>1365-2362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1u1DAURi1ERYeWV0DewIqk_ouTLFigUEqlqkiIquwsx7mmHpI4tZMyfXscZtRu8eZa9vmurw9CmJKcpnW2zSmXRca4ZDkjROaElkzkuxdo83TxEm0IoSJjdcmO0esYt4SQinL2Ch3TknDGhdgg0_gJptmNH7DGNuhfA4wz9hbPd4AfdPRTgBjdiFM1S4g-JDAmdvQP0K-nnTOzD2vEL7PxA-BE34EOM7ba9UuAU3RkdR_hzaGeoJsv5z-ar9nVt4vL5tNVZop1UNoJUwCU1PBOMmhBWwOWy7YG0RFqBdRCtKZltmMttOkPTDJTm0IXhgvG-Al6v-87BX-_QJzV4KKBvtcj-CUqWdW8ErJKYLUHTfAxBrBqCm7Q4VFRolbBaqtWj2r1qFbB6p9gtUvRt4c3lnaA7jl4MJqAdwdAR6P7pHQ0Lj5zFS0lp3XiPu65P66Hx_8eQJ03l-su5bN93sUZdk95HX4rWfKyULfXF4p9rxv6-fpW_eR_AecUps4</recordid><startdate>200611</startdate><enddate>200611</enddate><creator>Stoiser, B.</creator><creator>Mörtl, D.</creator><creator>Hülsmann, M.</creator><creator>Berger, R.</creator><creator>Struck, J.</creator><creator>Morgenthaler, N. G.</creator><creator>Bergmann, A.</creator><creator>Pacher, R.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200611</creationdate><title>Copeptin, a fragment of the vasopressin precursor, as a novel predictor of outcome in heart failure</title><author>Stoiser, B. ; Mörtl, D. ; Hülsmann, M. ; Berger, R. ; Struck, J. ; Morgenthaler, N. G. ; Bergmann, A. ; Pacher, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5014-1d4c5ee71c3d62ebeafcef36b9e4d01f4e944bcb2fd2beb170262c9c5a5c34223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cardiology. Vascular system</topic><topic>Chronic Disease</topic><topic>Copeptin</topic><topic>Female</topic><topic>General aspects</topic><topic>Glycopeptides - blood</topic><topic>Heart</topic><topic>heart failure</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Multivariate Analysis</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>natriuretic peptides</topic><topic>Predictive Value of Tests</topic><topic>prognosis</topic><topic>Prospective Studies</topic><topic>vasopressin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stoiser, B.</creatorcontrib><creatorcontrib>Mörtl, D.</creatorcontrib><creatorcontrib>Hülsmann, M.</creatorcontrib><creatorcontrib>Berger, R.</creatorcontrib><creatorcontrib>Struck, J.</creatorcontrib><creatorcontrib>Morgenthaler, N. G.</creatorcontrib><creatorcontrib>Bergmann, A.</creatorcontrib><creatorcontrib>Pacher, R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stoiser, B.</au><au>Mörtl, D.</au><au>Hülsmann, M.</au><au>Berger, R.</au><au>Struck, J.</au><au>Morgenthaler, N. G.</au><au>Bergmann, A.</au><au>Pacher, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Copeptin, a fragment of the vasopressin precursor, as a novel predictor of outcome in heart failure</atitle><jtitle>European journal of clinical investigation</jtitle><addtitle>Eur J Clin Invest</addtitle><date>2006-11</date><risdate>2006</risdate><volume>36</volume><issue>11</issue><spage>771</spage><epage>778</epage><pages>771-778</pages><issn>0014-2972</issn><eissn>1365-2362</eissn><abstract>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 < 0·0001) and age (χ2 = 4, P < 0·05) were independent predictors. Univariate predictors of re‐hospitalization due to heart failure were copeptin, BNP, age and impaired kidney function. Furthermore, in multivariate analysis BNP (χ2 = 18, P < 0·0001), age (χ2 = 11·8, P < 0·001) and copeptin (χ2 = 4·2, P < 0·05) were found to be independent predictors.
Conclusion Our study is the first to show that copeptin is an excellent predictor of outcome in advanced heart failure patients. Its value is superior to that of BNP in predicting death and a combined endpoint, although BNP is still suitable for predicting chronic heart failure (CHF) re‐hospitalization. Our data imply that vasopressin antagonism might be a new target to improve outcome in this population.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>17032344</pmid><doi>10.1111/j.1365-2362.2006.01724.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Biological and medical sciences Biomarkers - blood Cardiology. Vascular system Chronic Disease Copeptin Female General aspects Glycopeptides - blood Heart heart failure Heart Failure - diagnosis Heart Failure - mortality Heart Failure - physiopathology Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Male Medical sciences Multivariate Analysis Natriuretic Peptide, Brain - blood natriuretic peptides Predictive Value of Tests prognosis Prospective Studies vasopressin |
| title | Copeptin, a fragment of the vasopressin precursor, as a novel predictor of outcome in heart failure |
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