title: Copeptin for the prediction of recurrent cerebrovascular events after transient ischemic attack: results from the CoRisk study.
abstract: OBJECTIVE
  Copeptin has been associated with recurrent cerebrovascular events after transient ischemic attack (TIA). In an independent cohort, we evaluated copeptin for the prediction of recurrent cerebrovascular events within 3 months after TIA and assessed the incremental value of copeptin compared with the ABCD2 (age, blood, clinical features of TIA, duration of symptoms, presence of diabetes mellitus) and ABCD3-I (ABCD2, dual TIA [the presence of ≥2 TIA symptoms within 7 days], imaging [the presence of abnormal findings on neuroimaging]) scores.
  
  
  METHODS
  This prospective, multicenter cohort study was conducted at 3 tertiary Stroke Centers in Switzerland and Germany.
  
  
  RESULTS
  From March 2009 through April 2011, we included 302 patients with TIA admitted within 24 hours from symptom onset. Of 28 patients with a recurrent cerebrovascular event within 3 months (stroke or TIA), 11 patients had a stroke. Although the association of copeptin with recurrent cerebrovascular events was not significant, the association with stroke alone as end point was significant. After adjusting for the ABCD2 score, a 10-fold increase in copeptin levels was associated with an odds ratio for stroke of 3.39 (95% confidence interval, 1.28-8.96; P=0.01). After addition of copeptin to the ABCD2 score, the area under the curve of the ABCD2 score improved from 0.60 (95% confidence interval, 0.46-0.74) to 0.74 (95% confidence interval, 0.60-0.88, P=0.02). In patients with MRI (n=223), the area under the curve of the ABCD3-I score increased in similar magnitude, although not significantly. Based on copeptin, 31.2% of patients were correctly reclassified across the risk categories of the ABCD2 score (net reclassification improvement; P=0.17).
  
  
  CONCLUSIONS
  Copeptin improved the prognostic value of the ABCD2 score for the prediction of stroke but not TIA, and it may help clinicians in refining risk stratification for patients with TIA.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT00878813.
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: De Marchis
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Anja
authors.initials: A
authors.lastname: Weck
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Heinrich
authors.initials: H
authors.lastname: Audebert
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Steffen
authors.initials: S
authors.lastname: Benik
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Christian
authors.initials: C
authors.lastname: Foerch
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Daniela
authors.initials: D
authors.lastname: Buhl
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Philipp
authors.initials: P
authors.lastname: Schuetz
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Simon
authors.initials: S
authors.lastname: Jung
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Marleen
authors.initials: M
authors.lastname: Seiler
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Nils G
authors.initials: NG
authors.lastname: Morgenthaler
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Beat
authors.initials: B
authors.lastname: Mueller
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Mirjam
authors.initials: M
authors.lastname: Christ-Crain
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.).
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
authors.affiliation: From the Departments of Neurology and Clinical Chemistry, Inselspital, University of Bern, Bern, Switzerland (G.M.D.M., A.W., D.B., S.J., H.P.M., M.A.); Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY (G.M.D.M.); Department of Neurology (G.M.D.M.) and Department of Endocrinology (M.C.-C.), University Hospital of Basel, Basel, Switzerland; Departments of Neurology (H.A., S.B.) and Endocrinology (N.G.M.), Charité, Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology, Goethe University, Frankfurt am Main, Germany (C.F.); Medical University Department, Kantonsspital Aarau, Aarau, Switzerland (P.S., B.M.); Thermo Fisher Scientific Clinical Diagnostics BRAHMS GmbH, Hennigsdorf-Berlin, Germany (M.S.); and Department of Neurology, University Hospital of Zurich, Zurich, Switzerland (M.K.). mira.katan@usz.ch.
authors.forename: Mira
authors.initials: M
authors.lastname: Katan
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007118:Immunoassay; D002546:Ischemic Attack, Transient / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins
keywords: biomarker; copeptin; prediction; stroke; transient ischemic attack