title: Copeptin predicts 10-year all-cause mortality in community patients: a 10-year prospective cohort study.
abstract: BACKGROUND
  Copeptin, the C-terminal part of the arginine vasopressin (AVP) precursor peptide, is secreted in response to stress and correlates with adverse clinical outcomes in the acute-care hospital setting. There are no comprehensive data regarding its prognostic value in the community. We evaluated associations of copeptin levels with 10-year mortality in patients visiting their general practitioner (GP) for a respiratory infection included in a previous trial.
  
  
  METHODS
  This is a post hoc analysis including data from 359 patients included in the PARTI trial. Copeptin was measured in batch-analysis on admission and after 7 days. We calculated Cox regression models and area under the receiver operating characteristic curve (AUC) to assess an association of copeptin with mortality and adverse outcome. Follow-up data were collected by GP, patient and relative tracing through phone interviews 10 years after trial inclusion.
  
  
  RESULTS
  After a median follow-up of 10.0 years, mortality was 9.8%. Median admission copeptin levels (pmol/L) were significantly elevated in non-survivors compared to survivors (13.8, IQR 5.9-27.8; vs. 6.3 IQR 4.1-11.5; p<0.001). Admission copeptin levels were associated with 10-year all-cause mortality [age-adjusted hazard ratio 1.7 (95% CI, 1.2-2.5); p<0.001, AUC 0.68]. Results were similar for discharge copeptin levels. Copeptin also predicted adverse outcomes defined as death, pulmonary embolism and major adverse cardiac and cerebrovascular events.
  
  
  CONCLUSIONS
  In a sample of community-dwelling patients visiting their GP for a respiratory infection, copeptin levels were associated with 10-year all-cause mortality. In conjunction with traditional risk factors, this marker may help to better direct preventive measures in this population.
authors.forename: Jonas
authors.initials: J
authors.lastname: Odermatt
authors.forename: Rebekka
authors.initials: R
authors.lastname: Bolliger
authors.forename: Lara
authors.initials: L
authors.lastname: Hersberger
authors.forename: Manuel
authors.initials: M
authors.lastname: Ottiger
authors.forename: Mirjam
authors.initials: M
authors.lastname: Christ-Crain
authors.forename: Matthias
authors.initials: M
authors.lastname: Briel
authors.forename: Heiner C
authors.initials: HC
authors.lastname: Bucher
authors.forename: Beat
authors.initials: B
authors.lastname: Mueller
authors.forename: Philipp
authors.initials: P
authors.lastname: Schuetz
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012141:Respiratory Tract Infections / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins