Key result
In patients admitted for acute dyspnea, high admission copeptin levels (≥100 pmol/L) were associated with a significantly increased risk of 90-day death or rehospitalization compared to low levels (OR 16.2).
Cohort (n=336)
Single-blind
Yes
Changes in copeptin levels from admission to discharge provide significant prognostic value for 90-day mortality and rehospitalization in patients presenting to the emergency department with acute dyspnea.
May identify high-risk acute dyspnea patients; leaves open whether serial copeptin changes add prognostic value.
BACKGROUND: With patients referred to emergency departments (EDs) for acute dyspnea, emergency physicians should consider all possible diagnoses and assess patients' risk stratification. Copeptin has been shown to have prognostic power for subsequent events, such as death and rehospitalization in patients admitted for dyspnea. The aim of this study was to investigate prognostic role of copeptin variations during hospitalization in patients admitted for dyspnea. METHODS: We conducted a prospective, multicentric, observational study in acute dyspneic patients in three ED centers in Italy. Clinical data and copeptin assessments were performed at admission, and at discharge. A 90-day follow-up was performed. RESULTS: A total of 336 patients were enrolled, and on the basis of final diagnosis distinguished into two groups: acute heart failure and no acute heart failure. Compared to a control group, in all studied population copeptin values at admission resulted in a significantly (p<0.001) higher median (maximum-minimum): 31 (0-905) versus 8 (0-13) pmol/L. Median copeptin value at admission was 42 (0-905) pmol/L in acute heart failure patients and 20 (0-887) pmol/L in no acute heart failure, respectively (p<0.001). In all studied patients and in each group copeptin at admission and discharge showed significant predictive value for 90-day events (p<0.001). Furthermore, in all patients population and in both groups Δ copeptin values from admission to discharge also showed significant predictive value for 90-day events (p<0.001). CONCLUSIONS: In patients admitted for acute dyspnea, admission, discharge and Δ copeptin variations have significant prognostic value from subsequent 90-day death and rehospitalization.
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Vetrone et al. (2014) conducted a cohort in Acute dyspnea (n=336). Copeptin levels vs. Low copeptin levels (≤8 pmol/L) was evaluated on 90-day events (death and rehospitalization) (OR 16.2, p=<0.001). In patients admitted for acute dyspnea, high admission copeptin levels (≥100 pmol/L) were associated with a significantly increased risk of 90-day death or rehospitalization compared to low levels (OR 16.2).
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