title: The determination of copeptin levels helps management decisions among transient ischaemic attack patients.
abstract: BACKGROUND
  Most approaches to transient ischaemic attack (TIA) triage use clinical scores and vascular imaging; however, some biomarkers have been suggested to improve the prognosis of TIA patients.
  
  
  METHODS
  Serum levels of copeptin, adiponectin, neopterin, neuron-specific enolase, high-sensitivity C-reactive protein, IL-6, N-terminal pro-B-type natriuretic peptide, S100β, tumour necrosis factor-alpha and IL-1α as well as clinical characteristics were assessed on consecutive TIA patients during the first 24 h of the onset of symptoms.
  
  
  RESULTS
  Among 237 consecutive TIA patients, 12 patients (5%) had a stroke within 7 days and 15 (6%) within 90 days. Among all candidate biomarkers analysed, only copeptin was significantly increased in patients with stroke recurrence (SR) within 7 days (P = 0.026) but not within 90 days. A cut-off point of 13.8 pmol/l was established with a great predictive negative value (97.4%). Large artery atherosclerosis (LAA) [hazard ratio (HR) 12.7, 95% CI 3.2-50.1, P < 0.001] and copeptin levels ≥13.8 pmol/l (HR 3.9, 95% CI 1.01-14.4, P = 0.039) were independent predictors of SR at the 7-day follow-up. LAA was the only predictor of 90-day SR (HR 7.4, 95% CI 2.5-21.6, P < 0.001). ABCD3I was associated with 7- and 90-day SRs (P = 0.025 and P = 0.034, respectively). The association between copeptin levels and LAA had a diagnostic accuracy of 90.3%.
  
  
  CONCLUSIONS
  Serum copeptin could be an important prognostic biomarker to guide management decisions among TIA patients. Therefore, TIA patients with copeptin levels below 13.8 pmol/l and without LAA have an insignificant risk of 7-day SR and could be managed on an outpatient basis.
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Purroy
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Suárez-Luis
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Cambray
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Farré
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Benabdelhak
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Mauri-Capdevila
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sanahuja
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Quílez
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Begué
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: M I
authors.initials: MI
authors.lastname: Gil
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Molina-Seguin
authors.affiliation: Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociències Clíniques IRBLleida, Lleida, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Torreguitart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D019468:Disease Management; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D002546:Ischemic Attack, Transient / Q000097:blood* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; D015850:Interleukin-6; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; C048197:copeptins; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
keywords: biomarker; copeptin; prognosis; transient ischaemic attack