Open AccessClinical relevance of copeptin plasma levels as a biomarker of disease severity and mortality in critically ill patients
Author(s) -
Koch Alexander,
Yagmur Eray,
Hoss Alexander,
Buendgens Lukas,
Herbers Ulf,
Weiskirchen Ralf,
Koek Ger H.,
Trautwein Christian,
Tacke Frank
Publication year - 2018
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22614
Subject(s) - copeptin , medicine , biomarker , intensive care unit , sepsis , intensive care medicine , severity of illness , intensive care , septic shock , vasopressin , chemistry , biochemistry
Background Copeptin, also termed C‐terminal pre‐pro‐vasopressin or CT pro AVP , mirrors endogenous vasopressin (anti‐diuretic hormone, ADH ) activity and might thereby serve as a biomarker reflecting the biological stress level. We therefore hypothesized that copeptin plasma concentrations are associated with disease severity in critically ill patients and could predict mortality. Methods We analyzed plasma copeptin levels in a prospective, single‐center, observational study comprising 218 critically ill patients at admission to the medical intensive care unit ( ICU ). Mortality was assessed during a 2‐year observational follow‐up period. Results Copeptin plasma levels were significantly elevated in critically ill patients (n = 218) at ICU admission, as compared with 66 healthy controls. Neither sepsis as the cause of critical illness nor pre‐existing metabolic disorders (type 2 diabetes, obesity) were found to influence copeptin levels. On the contrary, plasma copeptin was closely associated with disease severity (eg APACHE ‐ II score) and correlated with biomarkers of inflammation, renal failure, metabolism, vascular tone, and tissue perfusion. Elevated copeptin levels at ICU admission predicted short‐term and long‐term mortality. Conclusions Copeptin plasma concentrations are significantly elevated in critically ill patients, correlate with disease severity and predict ICU and long‐term outcome. Thus, copeptin could be a promising tool for prognostication and management of critically ill patients.