title: Copeptin decrease from admission to discharge has favorable prognostic value for 90-day events in patients admitted with dyspnea.
abstract: BACKGROUND
  With patients referred to emergency departments (EDs) for acute dyspnea, emergency physicians should consider all possible diagnoses and assess patients' risk stratification. Copeptin has been shown to have prognostic power for subsequent events, such as death and rehospitalization in patients admitted for dyspnea. The aim of this study was to investigate prognostic role of copeptin variations during hospitalization in patients admitted for dyspnea.
  
  
  METHODS
  We conducted a prospective, multicentric, observational study in acute dyspneic patients in three ED centers in Italy. Clinical data and copeptin assessments were performed at admission, and at discharge. A 90-day follow-up was performed.
  
  
  RESULTS
  A total of 336 patients were enrolled, and on the basis of final diagnosis distinguished into two groups: acute heart failure and no acute heart failure. Compared to a control group, in all studied population copeptin values at admission resulted in a significantly (p<0.001) higher median (maximum-minimum): 31 (0-905) versus 8 (0-13) pmol/L. Median copeptin value at admission was 42 (0-905) pmol/L in acute heart failure patients and 20 (0-887) pmol/L in no acute heart failure, respectively (p<0.001). In all studied patients and in each group copeptin at admission and discharge showed significant predictive value for 90-day events (p<0.001). Furthermore, in all patients population and in both groups Δ copeptin values from admission to discharge also showed significant predictive value for 90-day events (p<0.001).
  
  
  CONCLUSIONS
  In patients admitted for acute dyspnea, admission, discharge and Δ copeptin variations have significant prognostic value from subsequent 90-day death and rehospitalization.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vetrone
authors.forename: Simona
authors.initials: S
authors.lastname: Santarelli
authors.forename: Veronica
authors.initials: V
authors.lastname: Russo
authors.forename: Irene
authors.initials: I
authors.lastname: Lalle
authors.forename: Benedetta
authors.initials: B
authors.lastname: De Berardinis
authors.forename: Laura
authors.initials: L
authors.lastname: Magrini
authors.forename: Enrico
authors.initials: E
authors.lastname: Di Stasio
authors.forename: Gerardo
authors.initials: G
authors.lastname: Salerno
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cardelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Piccoli
authors.forename: Marta
authors.initials: M
authors.lastname: Codognotto
authors.forename: Monica Maria
authors.initials: MM
authors.lastname: Mion
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Gianna
authors.initials: G
authors.lastname: Vettore
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Castello
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Avanzi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Somma
mesh_terms: D000368:Aged; D004417:Dyspnea / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D023381:Endpoint Determination; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission; D011379:Prognosis
chemical_list: D006020:Glycopeptides; C048197:copeptins