Prognostic value of copeptin: one-year outcome in patients with acute stroke.
OBJECTIVE
An accurate long-term outcome prediction may improve management of stroke patients. We investigated the ability of copeptin to predict 1-year outcome in stroke patients.


METHODS
In this preplanned post hoc analysis, the National Institutes of Health Stroke Scale score and copeptin levels were measured on admission in a cohort of patients with ischemic stroke. The primary end point was functional outcome (modified Rankin Scale score <3 or 3-6) after 1 year. The secondary end point was all-cause mortality.


RESULTS
Of 362 patients, 341 (94.2%) completed the 1-year follow-up, 146 (43%) patients had an unfavorable functional outcome, and 66 (20%) died. Multivariate logistic-regression analysis adjusted for age and National Institutes of Health Stroke Scale score showed that copeptin was an independent predictor of functional outcome (odds ratio=4.00; 95% CI, 1.94-8.19) and death (odds ratio=2.68; 95% CI, 1.24-5.82). The area under the receiver operating characteristic curve of copeptin was 0.72 (95% CI, 0.67-0.77) for functional outcome and 0.74 (95% CI, 0.69-0.78) for mortality. Copeptin improved the area under the receiver operating characteristic curve of the National Institutes of Health Stroke Scale score for functional outcome from 0.70 (95% CI, 0.64-0.74) to 0.76 (95% CI, 0.71-0.82; P=0.002) and for mortality from 0.74 (95% CI, 0.69-0.78) to 0.78 (95% CI, 0.71-0.85; P=0.04).


CONCLUSIONS
Copeptin levels are a useful, complementary tool to predict functional outcome and mortality 1 year after stroke.


BACKGROUND
ISCTRN 00390962; clinicaltrials.gov No. NCT00390962.
Urwyler
Sandrine A
SA
Schuetz
Philipp
P
Fluri
Felix
F
Morgenthaler
Nils G
NG
Zweifel
Christian
C
Bergmann
Andreas
A
Bingisser
Roland
R
Kappos
Ludwig
L
Steck
Andreas
A
Engelter
Stefan
S
Müller
Beat
B
Christ-Crain
Mirjam
M
Katan
Mira
M
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome
D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins