title: Plasma copeptin for short term risk stratification in acute pulmonary embolism.
abstract: Copeptin (COP) was reported to have prognostic value in various cardiovascular diseases. We hypothesized that COP levels reflect the severity of acute pulmonary embolism (PE) and may be useful in prognostic assessment. Plasma COP concentrations were measured on the Kryptor Compact Plus platform (BRAHMS, Hennigsdorf, Germany). The study included 107 consecutive patients with diagnosed acute PE (47 males, 60 females), with median age of 65 years (range 20-88). High risk PE was diagnosed in 3 patients (2.8 %), intermediate risk in 69 (64.5 %), and low risk PE in 35 (32.7 %) patients. Control group included 64 subjects (25 males, 39 females; median age 52.5 year, range 17-87). Four patients (3.7 %) died during 30-day observation. Complicated clinical course (CCC) was experienced by 10 (9.3 %) patients. COP level was higher in PE patients than in controls [11.55 pmol/L (5.16-87.97), and 19.00 pmol/L (5.51-351.90), respectively, p < 0.0001], and reflected PE severity. COP plasma concentration in low risk PE was 14.67 nmol/L (5.51-59.61) and in intermediate/high risk PE 19.84 mol/L (5.64-351.90) p < 0.05. Median COP levels in nonsurvivors was higher than in survivors, 84.6 (28.48-351.9) pmol/L and 18.68 (5.512-210.1) pmol/L, respectively, p = 0.009. Subjects with CCC presented higher COP levels than patients with benign clinical course 53.1 (17.95-351.9) pmol/L and 18.16 (5.51-210.1) pmol/L, respectively, p = 0.001. Log-transformed plasma COP was the significant predictor of CCC, OR 16.5 95 % CI 23.2-111.9, p < 0.001. AUC-for prediction of CCC using plasma COP was 0.811 (95 % CI 0.676-0.927). The COP cut off value of 17.95 nmol/l had sensitivity of 100 %, specificity 49.5 %, positive predictive value of 16.9 % and negative predictive value of 100 %. We conclude that plasma COP levels can be regarded for promising marker of severity of acute PE and show potential in risk stratification of these patients.
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Wyzgał
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Koć
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Szymon
authors.initials: S
authors.lastname: Pacho
authors.affiliation: Department of Psychology, University of Social Sciences and Humanities, Warsaw, Poland.
authors.forename: Maksymilian
authors.initials: M
authors.lastname: Bielecki
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Radosław
authors.initials: R
authors.lastname: Wawrzyniak
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Kostrubiec
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Ciurzyński
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kurnicka
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Goliszek
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Paczyńska
authors.affiliation: Department of Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Palczewski
authors.affiliation: Department of Internal Medicine and Cardiology, The Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland. piotr.pruszczyk@wum.edu.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Pruszczyk
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000401:mortality*; D018570:Risk Assessment; D015996:Survival Rate
chemical_list: D006020:Glycopeptides; C048197:copeptins
keywords: Copeptin; Low risk; Pulmonary embolism; Thromboembolism