Serum Copeptin Level as a Biomarker for Detecting Transient Ischemic Attack in the Emergency Room: A Prospective Case-Control Study

Objective We aimed to investigate the diagnostic accuracy of copeptin to detect transient ischemic attack (TIA) by comparing the plasma copeptin levels of patients diagnosed with TIA who were admitted to the Emergency Department (ED) with those of healthy controls. Materials and Methods We conducted a prospective case-control study among patients admitted to the ED with a neurological symptom. The patients diagnosed with TIA by the neurologist were included. The results of electrocardiography, magnetic resonance imaging, and carotid doppler ultrasonography investigations of 38 patients; the ED outcomes (hospitalization, discharge), the risk group distribution (according to ABCD2 scores), and the variables regarding one-year re-event incidence were compared. Additionally, the serum copeptin levels of the patients were compared to those of healthy controls. Results The mean copeptin level was 435.80 ± 316.45 pg/ml in the patient group, whereas it was 770.20 ± 912.53 pg/ml in the control group. The mean copeptin level of patients with TIA was significantly lower (p = 0.018). In the diagnosis of TIA, copeptin had 60.53% sensitivity and 68.42% specificity at a cut-off value of 386.28 pg/ ml, in all the participants. In addition, in participants above 60 years old, copeptin had 75.86% sensitivity and 72.41% specificity at a cut-off value of 460.37 pg/ ml. Conclusion To the best of our knowledge, this is the first study demonstrating the high efficacy of a serum biomarker in the diagnosis of TIA. Emergency physicians should search for alternative diagnoses in patients with a low degree of clinical suspicion and a lower copeptin value.