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van Dijk SHB, Brusse-Keizer MGJ, Bucsán CC, Ploumen EH, van Beurden WJC, van der Palen J, Doggen CJM, Lenferink A. Lack of Evidence Regarding Markers Identifying Acute Heart Failure in Patients with COPD: An AI-Supported Systematic Review. Int J Chron Obstruct Pulmon Dis 2024; 19:531-541. [PMID: 38414719 PMCID: PMC10898598 DOI: 10.2147/copd.s437899] [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: 09/26/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024] Open
Abstract
Background Due to shared symptoms, acute heart failure (AHF) is difficult to differentiate from an acute exacerbation of COPD (AECOPD). This systematic review aimed to identify markers that can diagnose AHF underlying acute dyspnea in patients with COPD presenting at the hospital. Methods All types of observational studies and clinical trials that investigated any marker's ability to diagnose AHF in acutely dyspneic COPD patients were considered eligible for inclusion. An AI tool (ASReview) supported the title and abstract screening of the articles obtained from PubMed, Scopus, Web of Science, the Cochrane Library, Embase, and CINAHL until April 2023. Full text screening was independently performed by two reviewers. Twenty percent of the data extraction was checked by a second reviewer and the risk of bias was assessed in duplicate using the QUADAS-2 tool. Markers' discriminative abilities were evaluated in terms of sensitivity, specificity, positive and negative predictive values, and the area under the curve when available. Results The search identified 10,366 articles. After deduplication, title and abstract screening was performed on 5,386 articles, leaving 153 relevant, of which 82 could be screened full text. Ten distinct studies (reported in 16 articles) were included, of which 9 had a high risk of bias. Overall, these studies evaluated 12 distinct laboratory and 7 non-laboratory markers. BNP, NT-proBNP, MR-proANP, and inspiratory inferior vena cava diameter showed the highest diagnostic discrimination. Conclusion There is not much evidence for the use of markers to diagnose AHF in acutely dyspneic COPD patients in the hospital setting. BNPs seem most promising, but should be interpreted alongside imaging and clinical signs, as this may lead to improved diagnostic accuracy. Future validation studies are urgently needed before any AHF marker can be incorporated into treatment decision-making algorithms for patients with COPD. Protocol Registration CRD42022283952.
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Affiliation(s)
- Sanne H B van Dijk
- Health Technology & Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Marjolein G J Brusse-Keizer
- Health Technology & Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
- Medical School Twente, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Charlotte C Bucsán
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands
- Cognition, Data & Education, Faculty of Behavioural, Management & Social Sciences, University of Twente, Enschede, the Netherlands
| | - Eline H Ploumen
- Health Technology & Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
- Department of Cardiology, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Wendy J C van Beurden
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Job van der Palen
- Medical School Twente, Medisch Spectrum Twente, Enschede, the Netherlands
- Cognition, Data & Education, Faculty of Behavioural, Management & Social Sciences, University of Twente, Enschede, the Netherlands
| | - Carine J M Doggen
- Health Technology & Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
- Clinical Research Centre, Rijnstate Hospital, Arnhem, the Netherlands
| | - Anke Lenferink
- Health Technology & Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands
- Clinical Research Centre, Rijnstate Hospital, Arnhem, the Netherlands
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2
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Abdelmageed M, Güzelgül F. Copeptin: Up-to-date diagnostic and prognostic role highlight. Anal Biochem 2023:115181. [PMID: 37247750 DOI: 10.1016/j.ab.2023.115181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023]
Abstract
Arginine Vasopressin (AVP) is one of the key hormones in the human body. AVP is clinically important because it maintains body fluid balance and vascular tone. Unfortunately, AVP laboratory measurements are always difficult and with low accuracy. Copeptin, the C-terminal of the AVP precursor, is released in equal amounts with AVP, making it a sensitive marker of AVP release. Despite being a non-specific biomarker, copeptin earned a lot of attention as a novel biomarker due to easy and quick laboratory measurements. Recent studies have reported the critical role of copeptin as a clinical indicator, especially in the diagnosis and prognosis of many diseases. Besides, it was reported that the combination between copeptin and gold standard biomarkers improved the prognostic values of those biomarkers. In this review, the role of copeptin as a new predictive diagnostic and prognostic biomarker of various diseases is highlighted according to the most recent studies. In addition, the importance of using copeptin as a marker in different medical departments and the impact of this on improving healthcare service was discussed.
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Affiliation(s)
- Marwa Abdelmageed
- Tokat Gaziosmanpasa University, Faculty of Medicine, Department of Medical Biochemistry, Tokat City, Turkiye.
| | - Figen Güzelgül
- Tokat Gaziosmanpasa University, Faculty of Pharmacy, Department of Biochemistry, Tokat City, Turkiye.
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3
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Review novel insights into the diagnostic and prognostic function of copeptin in daily clinical practice. Mol Biol Rep 2023; 50:3755-3765. [PMID: 36662451 PMCID: PMC9853489 DOI: 10.1007/s11033-023-08246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023]
Abstract
As is shown in previous reports, arginine vasopressin (AVP), as one of the most important hormones within circulation in human beings, is of great clinically significance given that it could maintain the body fluid balance and vascular tone. However, the laboratory measurements AVP in daily clinical practice are shown to be difficult and with low accuracy. Concerning on this notion, it is unpractical to use the serum levels of AVP in diagnosing multiple diseases. On the other hand, another key serum biomarker, copeptin, is confirmed as the C-terminal of the AVP precursor which could be released in equal amounts with AVP, resultantly making it as a sensitive marker of arginine vasopressin release. Notably, emerging recent evidence has demonstrated the critical function of copeptin as a clinical indicator, especially in the diagnosis and prognosis of several diseases in diverse organs, such as cardiovascular disease, kidney disease, and pulmonary disease. In addition, copeptin was recently verified to play an important role in diagnosing multiple acute diseases when combined it with other gold standard serum biomarkers, indicating that copeptin could be recognized as a vital disease marker. Herein, in the current review, the functions of copeptin as a new predictive diagnostic and prognostic biomarker of various diseases, according to the most recent studies, are well summarized. Furthermore, the importance of using copeptin as a serum biomarker in diverse medical departments and the impact of this on improving healthcare service is also summarized in the current review.
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4
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Mohan IK, Baba KSSS, Iyyapu R, Thirumalasetty S, Satish OS. Advances in congestive heart failure biomarkers. Adv Clin Chem 2022; 112:205-248. [PMID: 36642484 DOI: 10.1016/bs.acc.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Congestive heart failure (CHF) is the leading cause of morbidity and mortality in the elderly worldwide. Although many biomarkers associated with in heart failure, these are generally prognostic and identify patients with moderate and severe disease. Unfortunately, the role of biomarkers in decision making for early and advanced heart failure remains largely unexplored. Previous studies suggest the natriuretic peptides have the potential to improve the diagnosis of heart failure, but they still have significant limitations related to cut-off values. Although some promising cardiac biomarkers have emerged, comprehensive data from large cohort studies is lacking. The utility of multiple biomarkers that reflect various pathophysiologic pathways are increasingly being explored in heart failure risk stratification and to diagnose disease conditions promptly and accurately. MicroRNAs serve as mediators and/or regulators of renin-angiotensin-induced cardiac remodeling by directly targeting enzymes, receptors and signaling molecules. The role of miRNA in HF diagnosis is a promising area of research and further exploration may offer both diagnostic and prognostic applications and phenotype-specific targets. In this review, we provide insight into the classification of different biochemical and molecular markers associated with CHF, examine clinical usefulness in CHF and highlight the most clinically relevant.
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Affiliation(s)
| | - K S S Sai Baba
- Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, Telangana, India
| | - Rohit Iyyapu
- Katuri Medical College & Hospital, Guntur, Andhra Pradesh, India
| | | | - O Sai Satish
- Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, Telangana, India
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5
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Zimodro JM, Gasecka A, Jaguszewski M, Amanowicz S, Szkiela M, Denegri A, Pruc M, Duchnowski P, Peacock FW, Rafique Z, Szarpak L. Role of copeptin in diagnosis and outcome prediction in patients with heart failure: a systematic review and meta-analysis. Biomarkers 2022; 27:720-726. [PMID: 36083024 DOI: 10.1080/1354750x.2022.2123042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Introduction: This systematic review and meta-analysis of 19 studies, was conducted to evaluate the role of copeptin in diagnosis and outcome prediction in HF patients. Materials and Methods: A systematic literature search for clinical trials reporting copeptin levels in HF patients was performed using EMBASE, PubMed, Cochrane Register of Controlled Trials, and Google Scholar. Articles from databases published by January 2nd, 2022, that met the selection criteria were retrieved and reviewed. The random effects model was used for analyses. Results: Pooled analysis found higher mean copeptin levels in HF vs. non-HF populations (43.6 ± 46.4 vs. 21.4 ± 21.4; MD= 20.48; 95%CI: 9.22 to 31.74; p < 0.001). Pooled analysis of copeptin concentrations stratified by ejection fraction showed higher concentrations in HFrEF vs. HFpEF (17.4 ± 7.1 vs. 10.1 ± 5.5; MD= -4.69; 95%CI: -7.58 to -1.81; p = 0.001). Copeptin level was higher in patients with mortality/acute HF-related hospitalization vs. stable patients (31.3 ± 23.7 vs. 20.4 ± 12.8; MD= -13.06; 95%CI: -25.28 to -0.84; p = 0.04). Higher copeptin concentrations were associated with mortality and observed in all follow-up periods (p <0.05). Discussion and Conclusions: Present meta-analysis showed that elevated copeptin plasma concentrations observed in HF patients are associated with increased risk of all-cause mortality, thus copeptin may serve as predictor of outcome in HF.
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Affiliation(s)
- Jakub Michal Zimodro
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Milosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Sandra Amanowicz
- Students Research Club, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
| | - Marta Szkiela
- Students Research Club, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
| | - Andrea Denegri
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
| | - Piotr Duchnowski
- Cardinal Wyszynski National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA.,Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
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Mu D, Cheng J, Qiu L, Cheng X. Copeptin as a Diagnostic and Prognostic Biomarker in Cardiovascular Diseases. Front Cardiovasc Med 2022; 9:901990. [PMID: 35859595 PMCID: PMC9289206 DOI: 10.3389/fcvm.2022.901990] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/07/2022] [Indexed: 12/11/2022] Open
Abstract
Copeptin is the carboxyl-terminus of the arginine vasopressin (AVP) precursor peptide. The main physiological functions of AVP are fluid and osmotic balance, cardiovascular homeostasis, and regulation of endocrine stress response. Copeptin, which is released in an equimolar mode with AVP from the neurohypophysis, has emerged as a stable and simple-to-measure surrogate marker of AVP and has displayed enormous potential in clinical practice. Cardiovascular disease (CVD) is currently recognized as a primary threat to the health of the population worldwide, and thus, rapid and effective approaches to identify individuals that are at high risk of, or have already developed CVD are required. Copeptin is a diagnostic and prognostic biomarker in CVD, including the rapid rule-out of acute myocardial infarction (AMI), mortality prediction in heart failure (HF), and stroke. This review summarizes and discusses the value of copeptin in the diagnosis, discrimination, and prognosis of CVD (AMI, HF, and stroke), as well as the caveats and prospects for the application of this potential biomarker.
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Affiliation(s)
- Danni Mu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jin Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xinqi Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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7
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Biomarkers Associated with Cardiovascular Disease in COVID-19. Cells 2022; 11:cells11060922. [PMID: 35326373 PMCID: PMC8946710 DOI: 10.3390/cells11060922] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/20/2022] [Accepted: 03/05/2022] [Indexed: 02/08/2023] Open
Abstract
Coronavirus disease-19 (COVID-19) emerged late December 2019 in the city of Wuhan, China and has since spread rapidly all over the world causing a global pandemic. While the respiratory system is the primary target of disease manifestation, COVID-19 has been shown to also affect several other organs, making it a rather complex, multi-system disease. As such, cardiovascular involvement has been a topic of discussion since the beginning of the COVID-19 pandemic, primarily due to early reports of excessive myocardial injury in these patients. Treating physicians are faced with multiple challenges in the management and early triage of patients with COVID-19, as disease severity is highly variable ranging from an asymptomatic infection to critical cases rapidly deteriorating to intensive care treatment or even fatality. Laboratory biomarkers provide important prognostic information which can guide decision making in the emergency department, especially in patients with atypical presentations. Several cardiac biomarkers, most notably high-sensitive cardiac troponin (hs-cTn) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), have emerged as valuable predictors of prognosis in patients with COVID-19. The purpose of this review was to offer a concise summary on prognostic cardiac biomarkers in COVID-19 and discuss whether routine measurements of these biomarkers are warranted upon hospital admission.
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8
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Mu D, Ma C, Cheng J, Zou Y, Qiu L, Cheng X. Copeptin in fluid disorders and stress. Clin Chim Acta 2022; 529:46-60. [PMID: 35143773 DOI: 10.1016/j.cca.2022.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 12/16/2022]
Abstract
Copeptin, a glycosylated peptide of 39 amino acids, is the C-terminal segment of arginine vasopressin (AVP) precursor peptide, which is consisted of two other fragments, vasopressin and neurophysin Ⅱ. The main physiological functions of AVP are fluid and osmotic balance, cardiovascular homeostasis and regulation of the endocrine stress response. Numerous studies have demonstrated that the endogenous AVP in plasma is a meaningful biomarker to guide diagnosis and therapy of diseases associated with fluids disorders and stress. However, due to its instability, short half-time life in circulation and lack of readily available AVP assays, clinical measurement of AVP is restricted. In contrast to AVP, copeptin which is released in an equimolar mode with AVP from the pituitary, has emerged as a stable and simple-to-measure surrogate marker of AVP and displays excellent potential in diagnosis, differentiation and prognosis of various diseases. This review will discuss the studies on the clinical value of copeptin in different diseases, especially in AVP-dependent fluids disorders, as well as issues and prospects of the application of this potential biomarker.
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Affiliation(s)
- Danni Mu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Chaochao Ma
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Jin Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Yutong Zou
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xinqi Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China.
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9
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Săcărescu A, Turliuc MD, Brănișteanu DD. Role of copeptin in the diagnosis of traumatic neuroendocrine dysfunction. Neuropeptides 2021; 89:102167. [PMID: 34175655 DOI: 10.1016/j.npep.2021.102167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/08/2021] [Accepted: 06/20/2021] [Indexed: 11/22/2022]
Abstract
Traumatic neuroendocrine dysfunction may present with diabetes insipidus (DI) or with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Both these pathologies involve a disturbance in the antidiuretic hormone (ADH) secretion, causing dysnatremias. Diagnosis of posttraumatic ADH dysfunction is hampered by technical difficulties in ADH assessment, and relies mostly on non-specific serum sodium, serum and urine osmolality and diuresis, often leading to misdiagnosis in the acute care setting. Research now focuses on the diagnostic role of copeptin, a peptide secreted together with ADH in an equimolar fashion, and which can be accurately evaluated. Recent studies identified cut-off values of 2.6 pmol/L for baseline copeptin and of 4.9 and 3.8 pmol/L for hypertonic saline infusion and arginine infusion stimulated copeptin, respectively, for the diagnosis of DI in patients with polyuria-polydipsia syndrome. Although SIADH is more difficult to be explored due to its heterogeneity, a ratio of copeptin to urinary sodium below 30 pmol/mmol identifies euvolemic hyponatremia. Exploring the role of copeptin assessment in patients with traumatic brain injury (TBI) in the acute phase may improve their diagnosis accuracy, management and outcome.
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Affiliation(s)
- Alina Săcărescu
- Department of Medical Specialties II, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii, Iasi 700115, Romania; Department of Neurology, Clinical Rehabilitation Hospital, 14 Pantelimon Halipa, Iasi 700661, Romania.
| | - Mihaela-Dana Turliuc
- Department of Surgery II, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii, Iasi 700115, Romania; Department of Neurosurgery II, "Prof. Dr. N. Oblu" Clinical Emergency Hospital, 2 Ateneului, Iasi 700309, Romania
| | - Dumitru D Brănișteanu
- Department of Medical Specialties II, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii, Iasi 700115, Romania; Department of Endocrinology, "Sf. Spiridon" Clinical County Emergency Hospital", 1 Independentei, Iasi 700111, Romania
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10
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Paramanathan S, Grejs AM, Jeppesen AN, Søreide E, Kirkegaard H, Duez CHV. Copeptin as a Prognostic Marker in Prolonged Targeted Temperature Management After Out-of-Hospital Cardiac Arrest. Ther Hypothermia Temp Manag 2020; 11:216-222. [PMID: 32985950 DOI: 10.1089/ther.2020.0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim was to investigate blood concentrations of copeptin and the prognostication in 24 versus 48 hours of targeted temperature management (TTM) in patients resuscitated after out-of-hospital cardiac arrest. This is an exploratory biomarker substudy of the trial entitled; "Targeted temperature management for 48 vs 24 hours and neurologic outcome after out-of-hospital-cardiac-arrest: A randomized clinical trial." Patients were randomized to target temperature of 33°C ± 1°C for 24 (TTM24) or 48 (TTM48) hours. The primary outcome was copeptin concentrations compared with TTM at admission, 24, 48, and 72 hours (t24, t48, and t72) after reaching target temperature. Secondary outcomes were the association between copeptin and cerebral performance category (CPC) score after 6 months, and copeptin level between cerebral or noncerebral causes of death. Blood samples from 117 patients were analyzed from two Scandinavian sites. No significant differences in copeptin concentrations were found between TTM24 versus TTM48 at admission 211.3 μg/L (148-276.6) versus 179.8 μg/L (127-232.6) (p = 0.45), t24: 23.3 μg/L (16.5-30.2) versus 18.6 μg/L (13.3-23.9) (p = 0.25), t48: 28.8 μg/L (20.6-36.9) versus 19.7 μg/L (14.3-25.1) (p = 0.06), and t72: 23.3 μg/L (13.8-26.8) versus 31.6 μg/L (22-41.2) (p = 0.05). Copeptin concentrations were significantly higher in poor neurological outcome group at t24, t48, and t72 (p < 0.01), but not at admission (p = 0.19). The prognostic ability of copeptin (area under the receiver operating characteristic curve) was at admission: 0.59 (95% confidence intervals: 0.46-0.72), t24: 0.74 (0.63-0.86), t48: 0.8 (0.7-0.9), and t72: 0.76 (0.65-0.87). Copeptin levels were not significantly different in noncerebral compared with cerebral causes at admission: p = 0.41, t24: p = 0.52, t48: p = 0.15, and t72: p = 0.38. There were no differences in the level of copeptin in TTM24 versus TTM48. Blood concentrations of copeptin were associated with CPC at 6 months, and no association between levels of copeptin and cerebral versus noncerebral causes of death was observed.
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Affiliation(s)
| | - Anders Morten Grejs
- Department of Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Anni Nørgaard Jeppesen
- Research Centre for Emergency Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Eldar Søreide
- Critical Care and Anesthesiology Research Group, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hans Kirkegaard
- Research Centre for Emergency Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
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11
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Evaluation of Copeptin during Pulmonary Exacerbation in Cystic Fibrosis. Mediators Inflamm 2019; 2019:1939740. [PMID: 31736654 PMCID: PMC6816008 DOI: 10.1155/2019/1939740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/09/2019] [Accepted: 09/17/2019] [Indexed: 01/16/2023] Open
Abstract
Copeptin was found to be a stable biomarker of inflammation and stress response in cardiac, renal, metabolic, and respiratory conditions such as pneumonia. The aim of this study was to investigate the copeptin levels in biological fluids (serum and sputum supernatant) of cystic fibrosis pediatric patients during pulmonary exacerbation and remission and to investigate the possible influence of copeptin levels on disease severity and quality of life. Copeptin serum concentrations were measured in 28 pediatric cystic fibrosis (CF) patients: 13 in stable condition and 15 during pulmonary exacerbation. In 10 CF patients, copeptin was also measured in the sputum. In all the patients, we assessed complete blood count, BMI, sputum culture, lung function, and chest imaging (with Brasfield score). The severity of symptoms was assessed using the Shwachman-Kulczycki (SK) score, and the quality of life was assessed with the Cystic Fibrosis Quality of Life Questionnaire-Revised (CFQ-R). Copeptin concentrations in serum and sputum supernatant was measured using an ELISA kit. Statistical analysis was done in Statistica v.12. Serum and sputum copeptin levels were higher in CF patients during pulmonary exacerbation than in a stable period, but the differences were not significant (p = 0.58 and p = 0.13, respectively). Copeptin did not correlate significantly with any clinical, laboratory, or spirometry markers of exacerbation. There was, however, a significant inverse correlation between the serum copeptin level and symptoms severity (r = ‐0.77, p = 0.008) and radiological changes (r = ‐0.5626, p = 0.036) during pulmonary exacerbation in pediatric CF patients. Copeptin also inversely correlated with the quality of life domains in CF patients: vitality and eating habits, mostly loss of appetite (p = 0.031 and p = 0.016, respectively). Copeptin may be useful to identify patients with a higher risk of deterioration to improve their outcomes.
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12
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Pourafkari L, Tajlil A, Nader ND. Biomarkers in diagnosing and treatment of acute heart failure. Biomark Med 2019; 13:1235-1249. [PMID: 31580155 DOI: 10.2217/bmm-2019-0134] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Acute heart failure (AHF) is a complex disorder involving different pathophysiological pathways. In recent years, there is an increased focus on biomarkers that help with diagnosis, risk stratification and disease monitoring of AHF. Finding a reliable set of biomarkers not only improves morbidity and mortality but it can also potentially reveal the new targets of therapy. In this paper, we have reviewed the biomarkers found useful for the diagnosis as well as for risk stratification and prognostication in patients with AHF. We have discussed the established biomarkers for AHF including cardiac troponins and natriuretic peptides and emerging biomarkers including adiponectin, mi-RNA, sST2, Gal-3, MR-proADM, OPG, CT-proAVP and H-FABP for the purposes of making diagnosis, their use as a guide of therapy or for determination of prognosis.
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Affiliation(s)
- Leili Pourafkari
- Department of Anesthesiology, University at Buffalo, Buffalo, NY 14203, USA
| | - Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Nader D Nader
- Department of Anesthesiology, University at Buffalo, Buffalo, NY 14203, USA
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13
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Aydindogan E, Penque D, Zoidakis J. Systematic review on recent potential biomarkers of chronic obstructive pulmonary disease. Expert Rev Mol Diagn 2018; 19:37-45. [DOI: 10.1080/14737159.2018.1559054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Eda Aydindogan
- Department of Biochemistry, Institute of Natural Sciences, Ege University, Izmir, Turkey
| | - Deborah Penque
- Laboratory of Proteomics, Human Genetics Department, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisboa, Portugal
- ToxOmics- Centre of Toxicogenomics and Human Health, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Jerome Zoidakis
- Department of Biotechnology, Biomedical Research Foundation, Academy of Athens, Athens, Greece
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Castello LM, Bellan M. Commenting on “Prognostic and diagnostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease and acute heart failure: data from ACE 2 study” by Jacob A. Winther and colleagues. Respir Res 2018; 19:35. [PMID: 29490639 PMCID: PMC5831829 DOI: 10.1186/s12931-018-0738-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/11/2018] [Indexed: 11/17/2022] Open
Abstract
We would like to comment on the article entitled “Prognostic and diagnostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease and acute heart failure: data from ACE 2 study” by Jacob A. Winther and colleagues, in the light of the results of a multicentric study published in 2014 by Vetrone F. et al., in which 336 patients with dyspnea were enrolled in the Emergency Departments of three University Hospitals in Italy. These two studies confirm the prognostic role of copeptin in patients with dyspnea due to heart failure but, while Winther et al. performed the copeptin measurements only at admission, Vetrone et al. evaluated the time-course of copeptin plasma concentration from the admission to the hospital discharge. The results showed a better performance of copeptin measured at discharge as prognostic biomarker compared to copeptin at hospital admission; similarly, a lower reduction or an increase in copeptin concentration from admission to discharge was a strong prognostic predictor of unfavorable outcome. In our opinion this is a very important result, opening new perspectives for the use of copeptin as prognostic marker in HF patients.
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Bellan M, Castello LM, Pirisi M. Candidate Biomarkers of Liver Fibrosis: A Concise, Pathophysiology-oriented Review. J Clin Transl Hepatol 2018; 6:317-325. [PMID: 30271745 PMCID: PMC6160308 DOI: 10.14218/jcth.2018.00006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/25/2018] [Accepted: 05/03/2018] [Indexed: 12/11/2022] Open
Abstract
Repair of sustained liver injury results in fibrosis (i.e. the accumulation of extracellular matrix proteins), and ultimately the complete distortion of parenchymal architecture of the liver, which we call cirrhosis. Detecting and staging of fibrosis is thus a mainstay in the management of chronic liver diseases, since many clinically relevant decisions, such as starting treatment and/or monitoring for complications including hepatocellular carcinoma, may depend on it. The gold standard for fibrosis staging is liver biopsy, the role of which, however, is questioned nowadays because of cost, hazards and poor acceptance by patients. On the other hand, imaging techniques and/or measurement of direct and indirect serum markers have not proved to be completely satisfactory under all circumstances as alternatives to liver biopsy. Making progress in this field is now more crucial than ever, since treatments for established fibrosis appear on the horizon. Fine dissection of the pathways involved in the pathophysiology of liver diseases has put forward several novel candidate biomarkers of liver fibrosis, such as growth arrest-specific6, Mac-2-binding protein, osteopontin, placental growth factor, growth/differentiation factor 15 and hepatocyte growth factor. All molecules have been suggested to have potential to complement or substitute methods currently used to stage liver diseases. Here, we review the pros and cons for their use in this setting.
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Affiliation(s)
- Mattia Bellan
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, “Sant’Andrea Hospital”, Vercelli, Italy
- IRCAD, Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy
- *Correspondence to: Mattia Bellan, Department of Translational Medicine, Università del Piemonte Orientale UPO, via Solaroli 17, Novara (NO) 28100, Italy. Tel: +39-321-3733966, Fax: +39-321-3733361, E-mail:
| | - Luigi Mario Castello
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy
- Emergency Medicine Department, “AOU Maggiore della Carità”, Novara, Italy
| | - Mario Pirisi
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy
- Division of Internal Medicine, “AOU Maggiore della Carità, Novara, Italy
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16
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Xu L, Liu X, Wu S, Gai L. The clinical application value of the plasma copeptin level in the assessment of heart failure with reduced left ventricular ejection fraction: A cross-sectional study. Medicine (Baltimore) 2018; 97:e12610. [PMID: 30278578 PMCID: PMC6181596 DOI: 10.1097/md.0000000000012610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This study aimed to evaluate the clinical applicability of the plasma copeptin level to assess heart failure with reduced left ventricular ejection fraction (HFrEF).One hundred thirty-one patients with HFrEF, 127 patients with heart failure with preserved left ventricular ejection fraction (HFpEF), and 119 healthy candidates were involved. The basic data and examination results of patients were collected. The heart function of the patients with HFrEF and HFpEF were graded on the basis of the criteria of New York Heart Association (NYHA) classification. The plasma copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were tested using enzyme-linked immunosorbent assays (ELISAs).The copeptin and NT-proBNP levels were higher in the HFrEF group than in the HFpEF group. The copeptin and NT-proBNP values increased as the NYHA grade increased in the patients with HFrEF. However, for the patients with HFpEF, the copeptin levels did not change markedly as the NYHA grade increased. The copeptin levels were positively correlated with the NT-proBNP levels in the patients with HFrEF; however, there was no correlation between the copeptin and NT-proBNP values in the patients with HFpEF.Copeptin is involved in the process of progression in patients with HFrEF and the copeptin values might be useful for HFrEF prediction and assessment in the clinic.
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Affiliation(s)
- Lei Xu
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing
- Department of Internal Medicine, School Hospital of Beihua University, Jilin, China
| | - Xiaoming Liu
- Department of Internal Medicine, School Hospital of Beihua University, Jilin, China
| | - Shuo Wu
- Department of Internal Medicine, School Hospital of Beihua University, Jilin, China
| | - Luyue Gai
- Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing
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17
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Molinari L, Baldrighi M, Castello LM. Comment on “Copeptin in heart failure: Review and meta-analysis” by Zhong Y et al. Clin Chim Acta 2018; 482:14-15. [DOI: 10.1016/j.cca.2018.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
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Baldrighi M, Castello LM, Bartoli E. Copeptin in hyponatremia: is there a role for this biomarker in the diagnostic workup? Endocrine 2018; 60:384-385. [PMID: 29497972 PMCID: PMC5937902 DOI: 10.1007/s12020-018-1557-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 01/31/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Marco Baldrighi
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Luigi Mario Castello
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Ettore Bartoli
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
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Baldrighi M, Castello LM, Bartoli E. Comment on "Mild water restriction with or without urea for the longterm treatment of SIADH: Can urine osmolality help the choice?" by Decaux et al. Eur J Intern Med 2018; 52:e43-e44. [PMID: 29398247 DOI: 10.1016/j.ejim.2018.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Marco Baldrighi
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Luigi Mario Castello
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
| | - Ettore Bartoli
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
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Castello LM, Salmi L, Zanotti I, Gardino CA, Baldrighi M, Settanni F, Avanzi GC. The increase in copeptin levels in mild head trauma does not predict the severity and the outcome of brain damage. Biomark Med 2018; 12:555-563. [DOI: 10.2217/bmm-2018-0041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To investigate the copeptin prognostic role in mild head trauma. Methods: We enrolled 105 adult patients who entered the emergency room because of recent mild head trauma; we evaluated: clinical picture, imaging and laboratory data (including copeptin). Results: Copeptin resulted higher in mild head trauma patients compared with controls: 29.89 pmol/l versus 7.05 pmol/l (p = 0.0008). Copeptin failed in identifying patients with or without brain lesions detected by CT scan, and patients with or without adverse events during the 30 days follow-up. Conclusion: We confirmed that mild head trauma patients have a significantly higher copeptin plasma levels compared with controls. Nevertheless, we did not observe a significant role for copeptin in traumatic brain injury patients regarding brain damage and outcome.
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Affiliation(s)
- Luigi M Castello
- Department of Translational Medicine, Università del Piemonte Orientale UPO, via Solaroli, 17. 28100 – Novara, Italy
- AOU Maggiore della Carità, Corso Mazzini, 18. 28100 – Novara, Italy
| | - Livia Salmi
- Department of Translational Medicine, Università del Piemonte Orientale UPO, via Solaroli, 17. 28100 – Novara, Italy
| | - Isabella Zanotti
- AOU Maggiore della Carità, Corso Mazzini, 18. 28100 – Novara, Italy
| | - Clara A Gardino
- Department of Translational Medicine, Università del Piemonte Orientale UPO, via Solaroli, 17. 28100 – Novara, Italy
| | - Marco Baldrighi
- Department of Translational Medicine, Università del Piemonte Orientale UPO, via Solaroli, 17. 28100 – Novara, Italy
| | - Fabio Settanni
- Division of Endocrinology, Diabetology & Metabolism, Department of Medical Sciences, Università di Torino, Corso AM Dogliotti, 14. 10126 – Torino, Italy
| | - Gian C Avanzi
- Department of Translational Medicine, Università del Piemonte Orientale UPO, via Solaroli, 17. 28100 – Novara, Italy
- AOU Maggiore della Carità, Corso Mazzini, 18. 28100 – Novara, Italy
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