Plasma copeptin for short term risk stratification in acute pulmonary embolism

Anna Wyzgał , Marcin Koć , Szymon Pacho , Maksymilian Bielecki , Radosław Wawrzyniak , Maciej Kostrubiec , Michał Ciurzyński , Katarzyna Kurnicka , Sylwia Goliszek , Marzena Paczyńska , Piotr Palczewski , Piotr Pruszczyk

Abstract

Copeptin (COP) was reported to have prognostic value in various cardiovascular diseases. We hypothesized that COP levels reflect the severity of acute pulmonary embolism (PE) and may be useful in prognostic assessment. Plasma COP concentrations were measured on the Kryptor Compact Plus platform (BRAHMS, Hennigsdorf, Germany). The study included 107 consecutive patients with diagnosed acute PE (47 males, 60 females), with median age of 65 years (range 20--88). High risk PE was diagnosed in 3 patients (2.8 , intermediate risk in 69 (64.5 , and low risk PE in 35 (32.7  patients. Control group included 64 subjects (25 males, 39 females; median age 52.5 year, range 17--87). Four patients (3.7  died during 30-day observation. Complicated clinical course (CCC) was experienced by 10 (9.3  patients. COP level was higher in PE patients than in controls [11.55 pmol/L (5.16--87.97), and 19.00 pmol/L (5.51--351.90), respectively, p < 0.0001], and reflected PE severity. COP plasma concentration in low risk PE was 14.67 nmol/L (5.51--59.61) and in intermediate/high risk PE 19.84 mol/L (5.64--351.90) p < 0.05. Median COP levels in nonsurvivors was higher than in survivors, 84.6 (28.48--351.9) pmol/L and 18.68 (5.512--210.1) pmol/L, respectively, p = 0.009. Subjects with CCC presented higher COP levels than patients with benign clinical course 53.1 (17.95--351.9) pmol/L and 18.16 (5.51--210.1) pmol/L, respectively, p = 0.001. Log-transformed plasma COP was the significant predictor of CCC, OR 16.5 95 % CI 23.2--111.9, p < 0.001. AUC---for prediction of CCC using plasma COP was 0.811 (95 % CI 0.676--0.927). The COP cut off value of 17.95 nmol/l had sensitivity of 100  specificity 49.5  positive predictive value of 16.9 % and negative predictive value of 100  We conclude that plasma COP levels can be regarded for promising marker of severity of acute PE and show potential in risk stratification of these patients.
Author Anna Wyzgał
Anna Wyzgał,,
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, Marcin Koć
Marcin Koć,,
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, Szymon Pacho
Szymon Pacho,,
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, Maksymilian Bielecki (Wydział Psychologii)
Maksymilian Bielecki,,
- Wydział Psychologii
, Radosław Wawrzyniak
Radosław Wawrzyniak,,
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, Maciej Kostrubiec
Maciej Kostrubiec,,
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, Michał Ciurzyński
Michał Ciurzyński,,
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, Katarzyna Kurnicka
Katarzyna Kurnicka,,
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, Sylwia Goliszek
Sylwia Goliszek,,
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, Marzena Paczyńska
Marzena Paczyńska,,
-
et al.`
Journal seriesJournal of Thrombosis and Thrombolysis, ISSN 0929-5305, (A 20 pkt)
Issue year2015
Pages1-6
Publication size in sheets0.5
Keywords in EnglishCopeptin, Pulmonary embolism, Thromboembolism, Low risk
ASJC Classification2705 Cardiology and Cardiovascular Medicine; 2720 Hematology
DOIDOI:10.1007/s11239-015-1284-5
URL http://dx.doi.org/10.1007/s11239-015-1284-5
Languageen angielski
File
Wyzgal_CopeptinPJTTH_15.pdf 539.56 KB
Score (nominal)20
Publication indicators Scopus SNIP (Source Normalised Impact per Paper): 2015 = 0.782; WoS Impact Factor: 2015 = 1.884 (2) - 2015=1.915 (5)
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