title: Copeptin Levels Do Not Correlate With Cross-Clamping Time in Patients Undergoing Carotid Endarterectomy Under General Anesthesia.
abstract: Copeptin is a sensitive and more stable surrogate marker for arginine vasopressin. In this study, we evaluated copeptin levels in carotid endarterectomy (CEA) patients, perioperatively, to determine whether copeptin levels can be related to carotid artery cross clamping (CC) time and to postoperative neurological outcomes. Copeptin, interleukin 6, C-reactive protein, cortisol, and brain natriuretic peptide were measured preoperatively (T1) and 3 hours postoperatively (T3) as well as intraoperatively (T2). We recruited 77 patients. Values of copeptin rose gradually over the observed times: T1 = 7.9 (6.4-9.6), T2 = 12.6 (9.3-16.8), and T3 = 72.3 (49.1-111.2) pmol/L. There was a significant difference for repeated measurement ( P = .000, P = .000, and P = .000). Duration of carotid artery CC during CEA does not affect postoperative copeptin level (CC ≤ 13 minutes: 106.8 ± 93.6 pmol/L, CC > 13 minutes: 96.7 ± 89.1 pmol/L; P = .634). Preoperative copeptin level was significantly higher in patients with ulcerated plaque morphology. Activation of the stress axis in patients undergoing CEA results in copeptin elevation. Duration of CC during CEA does not affect postoperative copeptin levels.
authors: 1 Dedinje Cardiovascular Institute, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Dragana
authors: D
authors: Unic-Stojanovic
authors: 2 Laboratory of Radiobiology and Molecular Genetics, Institute Vinca, University of Belgrade, Belgrade, Serbia.
authors: Esma R
authors: ER
authors: Isenovic
authors: 1 Dedinje Cardiovascular Institute, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Miomir
authors: M
authors: Jovic
authors: 1 Dedinje Cardiovascular Institute, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Vera
authors: V
authors: Maravic-Stojkovic
authors: 3 Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.
authors: Milica
authors: M
authors: Miljkovic
authors: 3 Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia.
authors: Tamara
authors: T
authors: Gojkovic
authors: 4 Department of Anesthesiology Clinical Center of Serbia, Belgrade, Serbia.|5 Department of Statistics, School of Dentistry, University of Belgrade, Belgrade, Serbia.
authors: Biljana
authors: B
authors: Milicic
authors: 2 Laboratory of Radiobiology and Molecular Genetics, Institute Vinca, University of Belgrade, Belgrade, Serbia.
authors: Nikola
authors: N
authors: Bogdanovic
authors: 1 Dedinje Cardiovascular Institute, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Djordje
authors: D
authors: Radak
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D001127:Arginine Vasopressin / Q000097:blood; D002545:Brain Ischemia / Q000097:blood*; D016893:Carotid Stenosis / Q000097:blood / Q000601:surgery; D016894:Endarterectomy, Carotid; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D013525:Surgical Instruments
chemical_list: D006020:Glycopeptides; C048197:copeptins; D001127:Arginine Vasopressin
keywords: carotid endarterectomy; copeptin; cross clamping; stress response