title: Usefulness of plasma copeptin as a biomarker to predict the therapeutic effectiveness of metoprolol for postural tachycardia syndrome in children.
abstract: Metoprolol is clinically used to treat postural tachycardia syndrome (POTS) in children, but its effectiveness is unsatisfactory. Biomarkers to predict therapeutic efficacy are needed. We aimed to explore changes in the plasma copeptin level for assessing the therapeutic efficacy of metoprolol for POTS in children. We included 49 children with POTS and 25 healthy children as controls. Patients received metoprolol for 1.5 to 3 months. The plasma copeptin level was measured by sandwich immunoluminometric assay. The area under the receiver operating characteristic curve was used to explore the predictive value of the plasma copeptin level. The baseline plasma copeptin level was higher in children with POTS than controls (10.524 ± 2.016 vs 8.750 ± 1.419 pmol/L, p <0.001) and was lower for responders than nonresponders to metoprolol (9.377 ± 1.411 vs 12.054 ± 1.662 pmol/L, p = 0.003). The area under the receiver operating characteristic curve was 0.889 (95% confidence interval 0.799 to 0.980). With a baseline plasma copeptin level of 10.225 pmol/L as a cutoff, the sensitivity was 90.5% and specificity 78.6% in predicting the efficacy of metoprolol in children with POTS. In conclusion, the baseline plasma copeptin level can be used as a biomarker to predict the therapeutic effectiveness of metoprolol in children with POTS.
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, PR China.
authors.forename: Juan
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Pediatrics, The Capital Medical University, Shijitan Hospital, Beijing, PR China.
authors.forename: Shuxu
authors.initials: S
authors.lastname: Du
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, PR China.
authors.forename: Jinyan
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, PR China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Physiology and Pathophysiology, Peking University Health Sciences Centre, Beijing, PR China; Key Laboratory of Cardiovascular Sciences, Ministry of Education, PR China.
authors.forename: Chaoshu
authors.initials: C
authors.lastname: Tang
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, PR China.
authors.forename: Junbao
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, PR China. Electronic address: jinhongfang51@126.com.
authors.forename: Hongfang
authors.initials: H
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D002648:Child; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006020:Glycopeptides / Q000097:blood*; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage*; D054972:Postural Orthostatic Tachycardia Syndrome / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D011187:Posture / Q000502:physiology*; D011237:Predictive Value of Tests; D011498:Protein Precursors; D012372:ROC Curve; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D015415:Biomarkers; D006020:Glycopeptides; D011498:Protein Precursors; C048197:copeptins; D008790:Metoprolol