Change in plasma copeptin level after acute spontaneous basal ganglia hemorrhage.
High plasma copeptin levels are associated with mortality after intracerebral hemorrhage (ICH). However, there is a paucity of data available on whether copeptin is an independent prognostic marker of mortality. Thus, we sought to furthermore evaluate this relation. Thirty healthy controls and 86 patients with acute ICH were included. Plasma samples were obtained on admission and at days 1, 2, 3, 5, and 7 after ICH. Its concentration was measured by enzyme-linked immunosorbent assay. After ICH, plasma copeptin level in patients increased during the 6-h period immediately, peaked in 24h, decreased gradually thereafter, and was substantially higher than that in healthy controls during the 7-day period. A multivariate analysis showed plasma copeptin level was an independent predictor for 1-week mortality (odds ratio, 1.013; 95% confidence interval (CI), 1.003-1.023; P=0.009) and positively associated with hematoma volume (t=6.616, P<0.001). A receiver operating characteristic curve identified that a baseline plasma copeptin level >577.5pg/mL predicted 1-week mortality with 87.5% sensitivity and 72.2% specificity (area under curve (AUC), 0.873; 95% CI, 0.784-0.935). The AUC of the copeptin concentration was similar to those of Glasgow Coma Scale (GCS) scores and hematoma volumes (P=0.136 and 0.280). However, copeptin did not statistically significantly improve the AUCs of GCS scores and hematoma volumes (P=0.206 and 0.333). Hence, increased plasma copeptin level is associated with hematoma volume and an independent prognostic marker of mortality after ICH.
Department of Neurosurgery, The First Hangzhou Municipal People's Hospital, Nanjing Medical University, Hangzhou 310000, China.
Xiao-Qiao
XQ
Dong
Man
M
Huang
Wen-Hua
WH
Yu
Zu-Yong
ZY
Zhang
Qiang
Q
Zhu
Zhi-Hao
ZH
Che
Quan
Q
Du
Hao
H
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020145:Basal Ganglia Hemorrhage / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D015600:Glasgow Coma Scale; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D013997:Time Factors
D015415:Biomarkers; D001786:Blood Glucose; D006020:Glycopeptides; C048197:copeptins