title: Copeptin adds prognostic information after ischemic stroke: results from the CoRisk study.
abstract: OBJECTIVE
  To evaluate and validate the incremental value of copeptin in the prediction of outcome and complications as compared with established clinical variables.
  
  
  METHODS
  In this prospective, multicenter, cohort study, we measured copeptin in the emergency room within 24 hours from symptom onset in 783 patients with acute ischemic stroke. The 2 primary end points were unfavorable functional outcome (modified Rankin Scale score 3-6) and mortality within 90 days. Secondary end points were any of 5 prespecified complications during hospitalization.
  
  
  RESULTS
  In multivariate analysis, higher copeptin independently predicted unfavorable outcome (adjusted odds ratio 2.17 for any 10-fold copeptin increase [95% confidence interval {CI}, 1.46-3.22], p < 0.001), mortality (adjusted hazard ratio 2.40 for any 10-fold copeptin increase [95% CI, 1.60-3.60], p < 0.001), and complications (adjusted odds ratio 1.93 for any 10-fold copeptin increase [95% CI, 1.33-2.80], p = 0.001). The discriminatory accuracy, calculated with the area under the receiver operating characteristic curve, improved significantly for all end points when adding copeptin to the NIH Stroke Scale score and the multivariate models. Moreover, the combination of copeptin with a validated score encompassing both the NIH Stroke Scale and age led to a net reclassification improvement of 11.8% for functional outcome and of 37.2% for mortality.
  
  
  CONCLUSIONS
  In patients with ischemic stroke, copeptin is a validated blood marker that adds predictive information for functional outcome and mortality at 3 months beyond stroke severity and age. Copeptin seems to be a promising new blood marker for prediction of in-hospital complications.
authors.affiliation: Department of Neurology, Neuroradiology, and Clinical Chemistry, Inselspital, University of Bern, Switzerland.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: De Marchis
authors.forename: Mira
authors.initials: M
authors.lastname: Katan
authors.forename: Anja
authors.initials: A
authors.lastname: Weck
authors.forename: Felix
authors.initials: F
authors.lastname: Fluri
authors.forename: Christian
authors.initials: C
authors.lastname: Foerch
authors.forename: Oliver
authors.initials: O
authors.lastname: Findling
authors.forename: Philipp
authors.initials: P
authors.lastname: Schuetz
authors.forename: Daniela
authors.initials: D
authors.lastname: Buhl
authors.forename: Marwan
authors.initials: M
authors.lastname: El-Koussy
authors.forename: Henrik
authors.initials: H
authors.lastname: Gensicke
authors.forename: Marlen
authors.initials: M
authors.lastname: Seiler
authors.forename: Nils
authors.initials: N
authors.lastname: Morgenthaler
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.forename: Beat
authors.initials: B
authors.lastname: Mueller
authors.forename: Mirjam
authors.initials: M
authors.lastname: Christ-Crain
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012044:Regression Analysis; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D015912:Thrombolytic Therapy; D055815:Young Adult
chemical_list: D006020:Glycopeptides; C048197:copeptins