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Filipovic MG, Huber M, Kobel B, Bello C, Levis A, Andereggen L, Kakizaki R, Stüber F, Räber L, Luedi MM. Association of Preoperative Copeptin Levels with Risk of All-Cause Mortality in a Prospective Cohort of Adult Cardiac Surgery Patients. Cells 2024; 13:1197. [PMID: 39056779 PMCID: PMC11274732 DOI: 10.3390/cells13141197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
We aimed to investigate the association of preoperative copeptin, a new cardiovascular biomarker, with short- and long-term mortality in a cohort of adult patients undergoing cardiac surgery, including its potential as a prognostic marker for clinical outcome. Preoperative blood samples of the Bern Perioperative Biobank, a prospective cohort of adults undergoing cardiac surgery during 2019, were analyzed. The primary and secondary outcome measures were 30-day and 1-year all-cause mortality. Optimal copeptin thresholds were calculated with the Youden Index. Associations of copeptin levels with the two outcomes were examined with multivariable logistic regression models; their discriminatory capacity was assessed with the area under the receiver operating characteristic (AUROC). A total of 519 patients (78.4% male, median age 67 y (IQR: 60-73 y)) were included, with a median preoperative copeptin level of 7.6 pmol/L (IQR: 4.7-13.2 pmol/L). We identified an optimal threshold of 15.9 pmol/l (95%-CI: 7.7 to 46.5 pmol/L) for 30-day mortality and 15.9 pmol/L (95%-CI: 9.0 to 21.3 pmol/L) for 1-year all-cause mortality. Regression models featured an AUROC of 0.79 (95%-CI: 0.56 to 0.95) for adjusted log-transformed preoperative copeptin for 30-day mortality and an AUROC of 0.76 (95%-CI: 0.64 to 0.88) for 1-year mortality. In patients undergoing cardiac surgery, the baseline levels of copeptin emerged as a strong marker for 1-year all-cause death. Preoperative copeptin levels might possibly identify patients at risk for a complicated, long-term postoperative course, and therefore requiring a more rigorous postoperative observation and follow-up.
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Affiliation(s)
- Mark G. Filipovic
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (M.H.); (C.B.); (A.L.); (F.S.); (M.M.L.)
| | - Markus Huber
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (M.H.); (C.B.); (A.L.); (F.S.); (M.M.L.)
| | - Beatrice Kobel
- Department for BioMedical Research (DBMR), University of Bern, 3010 Bern, Switzerland;
| | - Corina Bello
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (M.H.); (C.B.); (A.L.); (F.S.); (M.M.L.)
| | - Anja Levis
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (M.H.); (C.B.); (A.L.); (F.S.); (M.M.L.)
| | - Lukas Andereggen
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland;
- Faculty of Medicine, University of Bern, 3010 Bern, Switzerland
| | - Ryota Kakizaki
- Department of Cardiology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (R.K.); (L.R.)
| | - Frank Stüber
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (M.H.); (C.B.); (A.L.); (F.S.); (M.M.L.)
| | - Lorenz Räber
- Department of Cardiology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (R.K.); (L.R.)
| | - Markus M. Luedi
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (M.H.); (C.B.); (A.L.); (F.S.); (M.M.L.)
- Department of Anaesthesiology and Pain Medicine, Cantonal Hospital of St. Gallen, 9000 St. Gallen, Switzerland
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Fähndrich S, Herr C, Teuteberg S, Alter P, Söhler S, Soriano D, Classen J, Adams J, Weinhold V, Watz H, Waschki B, Zeller T, Eichenlaub M, Trudzinski FC, Michels JD, Omlor A, Seiler F, Moneke I, Biertz F, Stolz D, Welte T, Kauczor HU, Kahnert K, Jörres RA, Vogelmeier CF, Bals R. Midregional proatrial naturetic peptide (MRproANP) and copeptin (COPAVP) as predictors of all-cause mortality in recently diagnosed mild to moderate COPD-results from COSYCONET. Respir Res 2024; 25:56. [PMID: 38267944 PMCID: PMC10809634 DOI: 10.1186/s12931-024-02690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/12/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND MRproANP and COPAVP are prognostic markers for mortality in chronic obstructive pulmonary disease (COPD). Furthermore, these biomarkers predict mortality due to cardiovascular diseases, which are important prognostically determining comorbidities in patients with COPD. However, less is known about these biomarkers in recently diagnosed mild to moderate COPD. Therefore, we analyzed these biomarkers as potential predictors of mortality in recently diagnosed mild to moderate COPD. METHODS The blood biomarkers considered were copeptin (COPAVP), midregional adrenomedullin (MRproADM), midregional proatrial naturetic peptide (MRproANP), and fibrinogen. Analyses were performed in patients with stable "recently diagnosed mild to moderate COPD" defined by GOLD grades 0-2 and diagnosis of COPD ≤ 5 years prior to inclusion into the COSYCONET cohort (COPD and Systemic Consequences-Comorbidities Network), using Cox regression analysis with stepwise adjustment for multiple COPD characteristics, comorbidities, troponin and NT-proBNP. RESULTS 655 patients with recently diagnosed mild to moderate COPD were included. In the initial regression model, 43 of 655 patients died during the 6-year follow-up, in the final model 27 of 487. Regression analyses with adjustment for confounders identified COPAVP and MRproANP as statistically robust biomarkers (p < 0.05 each) of all-cause mortality, while MRproADM and fibrinogen were not. The fourth quartile of MRproANP (97 pmol/L) was associated with a hazard ratio of 4.5 (95%CI: 1.6; 12.8), and the fourth quartile of COPAVP (9.2 pmol/L) with 3.0 (1.1; 8.0). The results for MRproANP were confirmed in the total cohort of grade 0-4 (n = 1470 finally). CONCLUSION In patients with recently diagnosed mild to moderate COPD, elevated values of COPVP and in particular MRproANP were robust, independent biomarkers for all-cause mortality risk after adjustment for multiple other factors. This suggests that these markers might be considered in the risk assessment of early COPD.
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Affiliation(s)
- S Fähndrich
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
| | - C Herr
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - S Teuteberg
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - P Alter
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
| | - S Söhler
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
| | - D Soriano
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - J Classen
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - J Adams
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - V Weinhold
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - H Watz
- Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany
| | - B Waschki
- LungenClinic Grosshansdorf, Member of the German Center for Lung Research (DZL), Airway Research Center North (ARCN), Grosshansdorf, Germany
- Pneumology, Hospital Itzehoe, Itzehoe, Germany
- University Heart & Vascular Center Hamburg, Department of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Zeller
- University Heart & Vascular Center Hamburg, Department of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - M Eichenlaub
- Department of Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - F C Trudzinski
- Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - J D Michels
- Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany
| | - A Omlor
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - F Seiler
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
| | - I Moneke
- Department of Thoracic Surgery, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - F Biertz
- Institute for Biostatistics, Hannover Medical School, Hannover, Germany
| | - D Stolz
- Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany
| | - T Welte
- Department of Respiratory Medicine, Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany
| | - H U Kauczor
- Diagnostic and Interventional Radiology, Member of the German Center of Lung Research, University Hospital Heidelberg, Heidelberg, Germany
| | - K Kahnert
- Department of Internal Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), LMU University Hospital, LMU Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - R A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich, Germany
| | - C F Vogelmeier
- Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany
- Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany
| | - R Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany
- Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, Saarbrücken, Germany
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