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Copeptin predicted prognosis in HF patients
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MUNICH — High levels of copeptin appear to be an independent predictor of mortality risk and severity of disease in patients with HF.
Stefan Störk, MD, PhD, and colleagues presented data on the prognostic ability of copeptin in 926 patients (mean age, 68 years; 71% men; 44% with NYHA Class III/IV) included in the Interdisciplinary Network Heart Failure Study. Researchers enrolled patients with reduced cardiac pump function (left ventricular ejection fraction <40%) prior to discharge after hospitalization for cardiac decompensation. Follow-up was performed at a series of 6-month intervals at the outpatient clinical or via structured phone calls.
The median copeptin level in the study was 20.4 pmol/L. Four quartiles of copeptin levels were studied:
- <10.1 pmol/L
- 10.1 to 20.3 pmol/L
- 20.4 to 40.6 pmol/L
- >40.6 pmol/L
“Low levels [of copeptin] predicted very good prognosis and high levels a very unfavorable prognosis,” Störk, from Julius-Maximilians University of Würzburg, Germany, said during a press conference at the European Society of Cardiology Congress 2012.
Increased copeptin levels were linked with older age and more advanced HF. The mean age of patients in the highest quartile was 76 years and the mean age of patients in the lowest quartile was 63 years. Sixty-one percent of patients in the highest quartile had NYHA Class III/IV vs. 28% in the lowest quartile (P<.01 for trend).
Risk for all-cause mortality also rose with increasing copeptin levels, results showed. Patients in the lowest quartile had a 10% increased risk after 540 days, patients in the second quartile (10.1 to 20.3 pmol/L) had a 12% increased risk, patients in the third quartile (20.4 to 40.6 pmol/L) had a 19% increased risk and patients in the highest quartile had a 39% increased risk.
“The prognostic ability of copeptin was retained after adjusting for important influencing factors such as severity of HF, age and renal function,” Störk said at the conference. The same prognostic ability was preserved when copeptin was re-measured in patients who survived after 6 months.
In other results, higher copeptin levels were linked with low glomerular filtration rate and decreased LV ejection fraction. In addition, the proportion of patients with diabetes and anemia also increased with rising copeptin levels.
“The potential clinical utility of such information needs to be tested in future studies,” Störk said. – by Katie Kalvaitis
For more information:
Berliner D. Abstract #5271. Presented at: the European Society for Cardiology Congress; Aug. 25-29, 2012; Munich.
Disclosure: This work was supported by the Competence Network Heart Failure Germany and the Comprehensive Heart Failure Center Würzburg. The data were analyzed using kits provided by Thermo Fisher Scientific.