title: Is copeptin level associated with 1-year mortality after out-of-hospital cardiac arrest? Insights from the Paris registry*.
abstract: OBJECTIVE
  The availability of circulating biomarkers that helps to identify early out-of-hospital cardiac arrest survivors who are at increased risk of long-term mortality remains challenging. Our aim was to prospectively study the association between copeptin and 1-year mortality in patients with out-of-hospital cardiac arrest admitted in a tertiary cardiac arrest center.
  
  
  METHODS
  Retrospective monocenter study.
  
  
  METHODS
  Tertiary cardiac arrest center in Paris, France.
  
  
  METHODS
  Copeptin was assessed at admission and day 3. Pre- and intrahospital factors associated with 1-year mortality were analyzed by multivariate Cox proportional analysis.
  
  
  METHODS
  None.
  
  
  RESULTS
  Two hundred ninety-eight consecutive out-of-hospital cardiac arrest patients (70.3% male; median age, 60.2 yr [49.9-71.4]) were admitted in a tertiary cardiac arrest center in Paris (France). After multivariate analysis, higher admission copeptin was associated with 1-year mortality with a threshold effect (hazard ratio(5th vs 1st quintile) = 1.64; 95% CI, 1.05-2.58; p = 0.03). Day 3 copeptin was associated with 1-year mortality in a dose-dependent manner (hazard ratio(2nd vs 1st quintile) = 1.87; 95% CI, 1.00-3.49; p = 0.05; hazard ratio(3rd vs 1st quintile) = 1.92; 95% CI, 1.02-3.64; p = 0.04; hazard ratio(4th vs 1st quintile) = 2.12; 95% CI, 1.14-3.93; p = 0.02; and hazard ratio(5th vs 1st quintile) = 2.75; 95% CI, 1.47-5.15; p < 0.01; p for trend < 0.01). For both admission and day 3 copeptin, association with 1-year mortality existed for out-of-hospital cardiac arrest of cardiac origin only (p for interaction = 0.05 and < 0.01, respectively). When admission and day 3 copeptin were mutually adjusted, only day 3 copeptin remained associated with 1-year mortality in a dose-dependent manner (p for trend = 0.01).
  
  
  CONCLUSIONS
  High levels of copeptin were associated with 1-year mortality independently from prehospital and intrahospital risk factors, especially in out-of-hospital cardiac arrest of cardiac origin. Day 3 copeptin was superior to admission copeptin: this could permit identification of out-of-hospital cardiac arrest survivors at increased risk of mortality and allow for close observation of such patients.
authors.affiliation: 1Medical Intensive Care Unit, Cochin Hospital, APHP, Paris, France. 2Paris Descartes University, Sorbonne Paris Cité, Paris, France. 3Sudden Death Expertise Centre, INSERM U970, Paris Cardiovascular Research Center, Paris, France. 4Emergency Department, Cochin Hospital, APHP, Paris, France. 5Department of Automated Biological Diagnosis, Cochin Hospital, APHP, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Geri
authors.forename: Florence
authors.initials: F
authors.lastname: Dumas
authors.forename: Camille
authors.initials: C
authors.lastname: Chenevier-Gobeaux
authors.forename: Adrien
authors.initials: A
authors.lastname: Bouglé
authors.forename: Fabrice
authors.initials: F
authors.lastname: Daviaud
authors.forename: Tristan
authors.initials: T
authors.lastname: Morichau-Beauchant
authors.forename: Xavier
authors.initials: X
authors.lastname: Jouven
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Mira
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pène
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Empana
authors.forename: Alain
authors.initials: A
authors.lastname: Cariou
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood* / Q000401:mortality*; D010297:Paris / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins