title: The diagnostic value of serum copeptin levels in an acute pulmonary embolism.
abstract: BACKGROUND
  Acute pulmonary embolism (APE) is a common disease which is associated with high mortality and morbidity. Circulating level of copeptin, which was demonstrated to be elevated in heart failure, acute myocardial infarction and pulmonary arterial hypertension, were reported to be independent predictors of poor outcome in recent studies. The aim of the present study was to investigate the clinical utility of copeptin in the diagnosis of APE.
  
  
  METHODS
  A total of 90 consecutive patients, admitted to emergency service due to acute chest pain and/or dyspnea and who underwent pulmonary computerized tomography angiography (CTA) due to suspicion of APE, were included in this prospective study. The patients diagnosed with APE were defined as APE (+) group and the remaining individuals with normal pulmonary CTA result were defined as APE (-) group.
  
  
  RESULTS
  Copeptin levels (7.76 ± 4.4 vs. 3.81 ± 1.34 ng/dL; p < 0.001) were higher in the APE (+) group as compared to the APE (-) group. Copeptin was significantly positively correlated with B-type natriuretic peptide (r = 0.434, p < 0.001), D-dimer (r = 0.315, p = 0.003) and troponin I (r = 0.300, p = 0.004) and inversely correlated with arterial oxygen saturations (r = -0.533, p < 0001). When the correlation of copeptin with right ventricular dysfunction parameters was investigated, it was significantly inversely correlated with the tricuspid annular plane systolic excursion (r = -0.521, p < 0.001) and positively correlated with right to left ventricle ratio (r = 0.329, p = 0.024). Copeptin (OR 1.836, 95% CI 1.171-2.878, p = 0.008) was found as a significant independent predictor of APE in a multivariate analysis, after adjusting for other risk parameters.
  
  
  CONCLUSIONS
  Copeptin is a promising new biomarker, which may be used to support the need for further investigations and to improve the diagnosis of patients with APE.
authors.forename: Ali Kemal
authors.initials: AK
authors.lastname: Kalkan
authors.forename: Derya
authors.initials: D
authors.lastname: Ozturk
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erturk
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Kalkan
authors.affiliation: Rize Kackar Government Hospital, Department of Cardiology, Rize. altugcakmak@hotmail.com.
authors.forename: Huseyin Altug
authors.initials: HA
authors.lastname: Cakmak
authors.forename: Ender
authors.initials: E
authors.lastname: Oner
authors.forename: Fatih
authors.initials: F
authors.lastname: Uzun
authors.forename: Omer
authors.initials: O
authors.lastname: Tasbulak
authors.forename: Turab
authors.initials: T
authors.lastname: Yakisan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celik
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins
keywords: acute pulmonary embolism; copeptin; diagnosis