Abstract | AIMS: METHODS AND RESULTS: From a subset of 224 patients of the OPTIMAAL study, blood samples were drawn at a mean of 3 days after AMI when all patients had signs and/or symptoms of heart failure or a left ventricular ejection fraction <0.35. Endpoints of interest were mortality (primary endpoint of OPTIMAAL) and a composite cardiovascular endpoint, including death, MI, stroke, and/or resuscitated cardiac arrest. Mean age was 67 +/- 10 years, and mean follow-up was 33 +/- 7 months. Using univariable Cox proportional hazards survival analysis, higher levels of copeptin, BNP, and NT-proBNP were all significantly related to both mortality and the composite cardiovascular endpoint (all P < 0.01). In a multivariable Cox proportional hazards model, including all three biomarkers and other relevant covariates, a doubling of copeptin was related to a 1.83 (1.26-2.64) times increased risk of mortality (P < 0.0001) and a 1.35 (1.05-1.72) times increased risk of the composite cardiovascular endpoint (P = 0.018). Receiver operating characteristic curves indicated that copeptin [area under curve (AUC) 0.81] was a stronger predictor of mortality compared with both BNP (AUC 0.66; P = 0.0063 vs. copeptin) and NT-proBNP (AUC 0.67; P = 0.0016 vs. copeptin). Finally, changes of copeptin levels after 1 month significantly added prognostic information to the baseline value. CONCLUSION: Copeptin is a strong and novel marker for mortality and morbidity in patients with heart failure after AMI. In this population, the predictive value of copeptin was even stronger than BNP and NT-proBNP.
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Authors | Adriaan A Voors, Stephan von Haehling, Stefan D Anker, Hans L Hillege, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Iain Squire, Dirk J van Veldhuisen, Kenneth Dickstein, OPTIMAAL Investigators |
Journal | European heart journal
(Eur Heart J)
Vol. 30
Issue 10
Pg. 1187-94
(May 2009)
ISSN: 1522-9645 [Electronic] England |
PMID | 19346228
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Glycopeptides
- Peptide Fragments
- copeptins
- pro-brain natriuretic peptide (1-76)
- Arginine Vasopressin
- Natriuretic Peptide, Brain
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Topics |
- Aged
- Arginine Vasopressin
(blood)
- Biomarkers
(blood)
- Enzyme-Linked Immunosorbent Assay
- Female
- Glycopeptides
(blood)
- Heart Failure
(blood, drug therapy, etiology, mortality)
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Myocardial Infarction
(blood, complications)
- Natriuretic Peptide, Brain
(blood)
- Peptide Fragments
(blood)
- Prognosis
- Sensitivity and Specificity
- Stroke Volume
(physiology)
- Time Factors
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