title: Plasma copeptin and long-term outcomes in acute ischemic stroke.
abstract: OBJECTIVE
  The identification of patients at highest risk for adverse outcome who are presenting with acute ischemic stroke to the emergency department remains a challenge. This study firstly investigates the long-term prognostic value of the stress marker copeptin in Chinese patients with acute ischemic stroke.
  
  
  METHODS
  In a prospective study, copeptin levels were measured using a new sandwich immunoassay on admission in plasma of 245 consecutive patients with an acute ischemic stroke. The prognostic value of copeptin to predict the functional outcome and mortality within one year was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors.
  
  
  RESULTS
  Patients with an unfavorable outcomes and non-survivors had significantly increased copeptin levels on admission (P < 0.0001 and P < 0.0001). Multivariate Cox regression analysis adjusted for common risk factors showed that copeptin was an independent predictor of functional outcome (hazard ratio = 3.88; 95% CI: 1.94-7.77) and non-survivors (hazard ratio = 5.99; 95% CI: 2.55-14.07). The area under the receiver operating characteristic curve of copeptin was 0.75 (95% CI, 0.70-0.82) for functional outcome and 0.867 (95% CI, 0.802-0.933) for mortality.
  
  
  CONCLUSIONS
  Copeptin levels are a novel and complementary biomarker to predict functional outcome and mortality 1 year after acute ischemic stroke.
authors.affiliation: Department of Neurology, First Hospital, Jilin University, Changchun, China; Department of Elderly Neurology, Heilongjiang Province Hospital, Harbin, China.
authors.forename: J-L
authors.initials: JL
authors.lastname: Zhang
authors.forename: C-H
authors.initials: CH
authors.lastname: Yin
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: L-B
authors.initials: LB
authors.lastname: Zhao
authors.forename: H-J
authors.initials: HJ
authors.lastname: Fu
authors.forename: J-C
authors.initials: JC
authors.lastname: Feng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China; D015331:Cohort Studies; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D017063:Outcome Assessment, Health Care; D012372:ROC Curve; D018709:Statistics, Nonparametric; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D006020:Glycopeptides; C048197:copeptins
keywords: 1-year outcome; acute ischemic stroke; copeptin; prognostic biomarker