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Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery 1/2021

Open Access 01-12-2021 | Stroke | Research

Copeptin: a potential blood biomarker for acute ischemic stroke

Authors: Mohammed I. Oraby, Rasha H. Soliman, Rehab M. Abd Elkareem, Amna I. Mohammed

Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Issue 1/2021

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Abstract

Background

Copeptin is a new blood biomarker for acute ischemic stroke which emerged to assist clinicians with decision-making. Serum copeptin can accurately reflect vasopressin concentration, which plays a role in aggravation of inflammatory responses, ions and neurotransmitters dysfunctions. The objective of this work was to investigate the relation between copeptin level as a blood biomarker and the short-term prognosis of acute ischemic stroke after 3 months. The current study included 45 patients with first ever acute ischemic stroke and 45 healthy volunteers as a control. Clinical evaluation, CT and MRI of the brain, NIHSS on admission, and mRS after 3 months were done for the patients, and all the patients and control were subjected to assessment of serum level of copeptin by ELISA technique.

Results

Copeptin level was significantly higher in patients with acute ischemic stroke compared to healthy control subjects (p-value = 0.001). Also, copeptin level was significantly higher in patients with severe stroke (NIHSS > 16) than in those with mild-to-moderate stroke (NIHSS 0–15) at presentation and in patients with unfavorable outcome (mRS 3–6) when compared to patients with favorable outcome (mRS 0–2) (p-value = 0.003 and 0.001, respectively).
Copeptin level was significantly lower in patients who received thrombolytic therapy with rTPA (p-value = 0.049).

Conclusion

Copeptin has an interesting potential as a new prognostic biomarker for patients with acute ischemic stroke as its level was significantly higher in patients with severe stroke and in patients with unfavorable outcome.
Literature
1.
go back to reference Nickel CH, Bingisser R, Morgenthaler NG. The role of copeptin as a diagnostic and prognostic biomarker for risk stratification in the emergency department. BMC Med. 2012;10:7.CrossRef Nickel CH, Bingisser R, Morgenthaler NG. The role of copeptin as a diagnostic and prognostic biomarker for risk stratification in the emergency department. BMC Med. 2012;10:7.CrossRef
2.
go back to reference Katan M, Fluri F, Morgenthaler NG, Schuetz P, Zweifel C, Bingisser R, et al. Copeptin: a novel, independent prognostic marker in patients with ischemic stroke. Ann Neurol. 2009;66(6):799–808.CrossRef Katan M, Fluri F, Morgenthaler NG, Schuetz P, Zweifel C, Bingisser R, et al. Copeptin: a novel, independent prognostic marker in patients with ischemic stroke. Ann Neurol. 2009;66(6):799–808.CrossRef
3.
go back to reference Sultan SM, Schupf N, Dowling MM, Deveber GA, Kirton A, Elkind MS. Review of lipid and lipoprotein(a) abnormalities in childhood arterial ischemic stroke. Int J Stroke. 2014;9(1):79–87.CrossRef Sultan SM, Schupf N, Dowling MM, Deveber GA, Kirton A, Elkind MS. Review of lipid and lipoprotein(a) abnormalities in childhood arterial ischemic stroke. Int J Stroke. 2014;9(1):79–87.CrossRef
4.
go back to reference Barreca T, Gandolfo C, Corsini G, Del Sette M, Cataldi A, Rolandi E, et al. Evaluation of the secretory pattern of plasma arginine vasopressin in stroke patients. Cerebrovasc Dis. 2001;11(2):113–8.CrossRef Barreca T, Gandolfo C, Corsini G, Del Sette M, Cataldi A, Rolandi E, et al. Evaluation of the secretory pattern of plasma arginine vasopressin in stroke patients. Cerebrovasc Dis. 2001;11(2):113–8.CrossRef
5.
go back to reference Chung JW, Park SH, Kim N, Kim WJ, Park JH, Ku Y, et al. Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification and vascular territory of ischemic stroke lesions diagnosed by diffusion-weighted imaging. J Am Heart Assoc. 2014;3(4): e001119.CrossRef Chung JW, Park SH, Kim N, Kim WJ, Park JH, Ku Y, et al. Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification and vascular territory of ischemic stroke lesions diagnosed by diffusion-weighted imaging. J Am Heart Assoc. 2014;3(4): e001119.CrossRef
7.
go back to reference Sacco RL, Diener HC, Yusuf S, Cotton D, Ounpuu S, Lawton WA, et al. Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke. N Engl J Med. 2008;359(12):1238–51.CrossRef Sacco RL, Diener HC, Yusuf S, Cotton D, Ounpuu S, Lawton WA, et al. Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke. N Engl J Med. 2008;359(12):1238–51.CrossRef
8.
go back to reference Bonita R, Beaglehole R. Modification of Rankin Scale: recovery of motor function after stroke. Stroke. 1988;19(12):1497–500.CrossRef Bonita R, Beaglehole R. Modification of Rankin Scale: recovery of motor function after stroke. Stroke. 1988;19(12):1497–500.CrossRef
9.
go back to reference Sims JR, Gharai LR, Schaefer PW, Vangel M, Rosenthal ES, Lev MH, et al. ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes. Neurology. 2009;72(24):2104–10.CrossRef Sims JR, Gharai LR, Schaefer PW, Vangel M, Rosenthal ES, Lev MH, et al. ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes. Neurology. 2009;72(24):2104–10.CrossRef
10.
go back to reference Christ-Crain M, Fenske W. Copeptin in the diagnosis of vasopressin-dependent disorders of fluid homeostasis. Nat Rev Endocrinol. 2016;12(3):168–76.CrossRef Christ-Crain M, Fenske W. Copeptin in the diagnosis of vasopressin-dependent disorders of fluid homeostasis. Nat Rev Endocrinol. 2016;12(3):168–76.CrossRef
11.
go back to reference Zeng X, Deng A, Ding Y, Ni Y, Xu T, Liu J, et al. Copeptin and NT-proBNP as prognostic markers for recurrent ischemic cerebrovascular events in ischemic stroke patients. J Am Coll Cardiol. 2016;68(24):2710–1.CrossRef Zeng X, Deng A, Ding Y, Ni Y, Xu T, Liu J, et al. Copeptin and NT-proBNP as prognostic markers for recurrent ischemic cerebrovascular events in ischemic stroke patients. J Am Coll Cardiol. 2016;68(24):2710–1.CrossRef
12.
go back to reference Dong X, Tao DB, Wang YX, Cao H, Xu YS, Wang QY. Plasma copeptin levels in Chinese patients with acute ischemic stroke: a preliminary study. Neurol Sci. 2013;34(9):1591–5.CrossRef Dong X, Tao DB, Wang YX, Cao H, Xu YS, Wang QY. Plasma copeptin levels in Chinese patients with acute ischemic stroke: a preliminary study. Neurol Sci. 2013;34(9):1591–5.CrossRef
13.
go back to reference Maestrini I, Ducroquet A, Moulin S, Leys D, Cordonnier C, Bordet R. Blood biomarkers in the early stage of cerebral ischemia. Rev Neurol (Paris). 2016;172(3):198–219.CrossRef Maestrini I, Ducroquet A, Moulin S, Leys D, Cordonnier C, Bordet R. Blood biomarkers in the early stage of cerebral ischemia. Rev Neurol (Paris). 2016;172(3):198–219.CrossRef
14.
go back to reference Lim CT, Khoo B, et al. Normal physiology of ACTH and GH Release in the hypothalamus and anterior pituitary in man. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2020. Lim CT, Khoo B, et al. Normal physiology of ACTH and GH Release in the hypothalamus and anterior pituitary in man. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2020.
15.
go back to reference Armstead WM. Vasopressin-induced protein kinase C-dependent superoxide generation contributes to ATP-sensitive potassium channel but not calcium-sensitive potassium channel function impairment after brain injury. Stroke. 2001;32(6):1408–14.CrossRef Armstead WM. Vasopressin-induced protein kinase C-dependent superoxide generation contributes to ATP-sensitive potassium channel but not calcium-sensitive potassium channel function impairment after brain injury. Stroke. 2001;32(6):1408–14.CrossRef
16.
go back to reference Sposato LA, Cipriano LE, Saposnik G, Ruíz Vargas E, Riccio PM, Hachinski V. Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol. 2015;14(4):377–87.CrossRef Sposato LA, Cipriano LE, Saposnik G, Ruíz Vargas E, Riccio PM, Hachinski V. Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol. 2015;14(4):377–87.CrossRef
17.
go back to reference Wendt M, Ebinger M, Kunz A, Rozanski M, Waldschmidt C, Weber JE, et al. Copeptin levels in patients with acute ischemic stroke and stroke mimics. Stroke. 2015;46(9):2426–31.CrossRef Wendt M, Ebinger M, Kunz A, Rozanski M, Waldschmidt C, Weber JE, et al. Copeptin levels in patients with acute ischemic stroke and stroke mimics. Stroke. 2015;46(9):2426–31.CrossRef
18.
go back to reference Navis A, Garcia-Santibanez R, Skliut M. Epidemiology and outcomes of ischemic stroke and transient ischemic attack in the adult and geriatric population. J Stroke Cerebrovasc Dis. 2019;28(1):84–9.CrossRef Navis A, Garcia-Santibanez R, Skliut M. Epidemiology and outcomes of ischemic stroke and transient ischemic attack in the adult and geriatric population. J Stroke Cerebrovasc Dis. 2019;28(1):84–9.CrossRef
19.
go back to reference Molnár AH, Varga C, Berkó A, Rojik I, Párducz A, László F, et al. Inhibitory effect of vasopressin receptor antagonist OPC-31260 on experimental brain oedema induced by global cerebral ischaemia. Acta Neurochir (Wien). 2008;150(3):265–71.CrossRef Molnár AH, Varga C, Berkó A, Rojik I, Párducz A, László F, et al. Inhibitory effect of vasopressin receptor antagonist OPC-31260 on experimental brain oedema induced by global cerebral ischaemia. Acta Neurochir (Wien). 2008;150(3):265–71.CrossRef
20.
go back to reference Dobsa L, Edozien KC. Copeptin and its potential role in diagnosis and prognosis of various diseases. Biochem Med (Zagreb). 2013;23(2):172–90.CrossRef Dobsa L, Edozien KC. Copeptin and its potential role in diagnosis and prognosis of various diseases. Biochem Med (Zagreb). 2013;23(2):172–90.CrossRef
21.
go back to reference Wang CB, Zong M, Lu SQ, Tian Z. Plasma copeptin and functional outcome in patients with ischemic stroke and type 2 diabetes. J Diabetes Complications. 2016;30(8):1532–6.CrossRef Wang CB, Zong M, Lu SQ, Tian Z. Plasma copeptin and functional outcome in patients with ischemic stroke and type 2 diabetes. J Diabetes Complications. 2016;30(8):1532–6.CrossRef
22.
go back to reference Montaner J, Perea-Gainza M, Delgado P, Ribó M, Chacón P, Rosell A, et al. Etiologic diagnosis of ischemic stroke subtypes with plasma biomarkers. Stroke. 2008;39(8):2280–7.CrossRef Montaner J, Perea-Gainza M, Delgado P, Ribó M, Chacón P, Rosell A, et al. Etiologic diagnosis of ischemic stroke subtypes with plasma biomarkers. Stroke. 2008;39(8):2280–7.CrossRef
23.
go back to reference Holmes CL, Landry DW, Granton JT. Science review: vasopressin and the cardiovascular system part 1–receptor physiology. Crit Care. 2003;7(6):427–34.CrossRef Holmes CL, Landry DW, Granton JT. Science review: vasopressin and the cardiovascular system part 1–receptor physiology. Crit Care. 2003;7(6):427–34.CrossRef
24.
go back to reference Morgenthaler NG, Struck J, Alonso C, Bergmann A. Assay for the measurement of copeptin, a stable peptide derived from the precursor of vasopressin. Clin Chem. 2006;52(1):112–9.CrossRef Morgenthaler NG, Struck J, Alonso C, Bergmann A. Assay for the measurement of copeptin, a stable peptide derived from the precursor of vasopressin. Clin Chem. 2006;52(1):112–9.CrossRef
25.
go back to reference Müller B, Morgenthaler N, Stolz D, Schuetz P, Müller C, Bingisser R, et al. Circulating levels of copeptin, a novel biomarker, in lower respiratory tract infections. Eur J Clin Invest. 2007;37(2):145–52.CrossRef Müller B, Morgenthaler N, Stolz D, Schuetz P, Müller C, Bingisser R, et al. Circulating levels of copeptin, a novel biomarker, in lower respiratory tract infections. Eur J Clin Invest. 2007;37(2):145–52.CrossRef
26.
go back to reference Markus R, Reutens DC, Kazui S, Read S, Wright P, Pearce DC, et al. Hypoxic tissue in ischaemic stroke: persistence and clinical consequences of spontaneous survival. Brain. 2004;127(Pt 6):1427–36.CrossRef Markus R, Reutens DC, Kazui S, Read S, Wright P, Pearce DC, et al. Hypoxic tissue in ischaemic stroke: persistence and clinical consequences of spontaneous survival. Brain. 2004;127(Pt 6):1427–36.CrossRef
27.
go back to reference Giannopoulos G, Deftereos S, Panagopoulou V, Kossyvakis C, Kaoukis A, Bouras G, et al. Copeptin as a biomarker in cardiac disease. Curr Top Med Chem. 2013;13(2):231–40.CrossRef Giannopoulos G, Deftereos S, Panagopoulou V, Kossyvakis C, Kaoukis A, Bouras G, et al. Copeptin as a biomarker in cardiac disease. Curr Top Med Chem. 2013;13(2):231–40.CrossRef
28.
go back to reference El Dayem SMA, Battah AA, El Bohy AEM, Yousef RN, Talaat A. Copeptin as a biomarker of atherosclerosis in type 1 diabetic patients. Open Access Maced J Med Sci. 2020;7(23):3975–8.CrossRef El Dayem SMA, Battah AA, El Bohy AEM, Yousef RN, Talaat A. Copeptin as a biomarker of atherosclerosis in type 1 diabetic patients. Open Access Maced J Med Sci. 2020;7(23):3975–8.CrossRef
29.
go back to reference Furlanis G, Ajčević M, Buoite Stella A, Cillotto T, Caruso P, et al. Wake-up stroke: thrombolysis reduces ischemic lesion volume and neurological deficit. J Neurol. 2020;267(3):666–73.CrossRef Furlanis G, Ajčević M, Buoite Stella A, Cillotto T, Caruso P, et al. Wake-up stroke: thrombolysis reduces ischemic lesion volume and neurological deficit. J Neurol. 2020;267(3):666–73.CrossRef
30.
go back to reference Reganon E, Vila V, Martínez-Sales V, Vaya A, Lago A, Alonso P, et al. Association between inflammation and hemostatic markers in atherothrombotic stroke. Thromb Res. 2003;112(4):217–21.CrossRef Reganon E, Vila V, Martínez-Sales V, Vaya A, Lago A, Alonso P, et al. Association between inflammation and hemostatic markers in atherothrombotic stroke. Thromb Res. 2003;112(4):217–21.CrossRef
31.
go back to reference Choi KS, Kim HJ, Chun HJ, Kim JM, Yi HJ, et al. Prognostic role of copeptin after stroke: a systematic review and meta-analysis of observational studies. Sci Rep. 2015;5:11665.CrossRef Choi KS, Kim HJ, Chun HJ, Kim JM, Yi HJ, et al. Prognostic role of copeptin after stroke: a systematic review and meta-analysis of observational studies. Sci Rep. 2015;5:11665.CrossRef
32.
go back to reference Xu Q, Tian Y, Peng H, Li H. Copeptin as a biomarker for prediction of prognosis of acute ischemic stroke and transient ischemic attack: a meta-analysis. Hypertens Res. 2017;40(5):465–71.CrossRef Xu Q, Tian Y, Peng H, Li H. Copeptin as a biomarker for prediction of prognosis of acute ischemic stroke and transient ischemic attack: a meta-analysis. Hypertens Res. 2017;40(5):465–71.CrossRef
33.
go back to reference Trabold R, Krieg S, Schöller K, Plesnila N. Role of vasopressin V(1a) and V2 receptors for the development of secondary brain damage after traumatic brain injury in mice. J Neurotrauma. 2008;25(12):1459–65.CrossRef Trabold R, Krieg S, Schöller K, Plesnila N. Role of vasopressin V(1a) and V2 receptors for the development of secondary brain damage after traumatic brain injury in mice. J Neurotrauma. 2008;25(12):1459–65.CrossRef
34.
go back to reference Jochberger S, Mayr VD, Luckner G, Wenzel V, Ulmer H, Schmid S, et al. Serum vasopressin concentrations in critically ill patients. Crit Care Med. 2006;34(2):293–9.CrossRef Jochberger S, Mayr VD, Luckner G, Wenzel V, Ulmer H, Schmid S, et al. Serum vasopressin concentrations in critically ill patients. Crit Care Med. 2006;34(2):293–9.CrossRef
35.
go back to reference Deveci F, Öner Ö, Telo S, Kırkıl G, Balin M, Kuluöztürk M. Prognostic value of copeptin in patients with acute pulmonary thromboembolism. Clin Respir J. 2019;13(10):630–6.CrossRef Deveci F, Öner Ö, Telo S, Kırkıl G, Balin M, Kuluöztürk M. Prognostic value of copeptin in patients with acute pulmonary thromboembolism. Clin Respir J. 2019;13(10):630–6.CrossRef
Metadata
Title
Copeptin: a potential blood biomarker for acute ischemic stroke
Authors
Mohammed I. Oraby
Rasha H. Soliman
Rehab M. Abd Elkareem
Amna I. Mohammed
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
Keywords
Stroke
Biomarkers
DOI
https://doi.org/10.1186/s41983-021-00393-2

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