Copeptin, IGFBP-1, and cardiovascular prognosis in patients with type 2 diabetes and acute myocardial infarction: a report from the DIGAMI 2 trial.

Abstract

OBJECTIVE:

To determine whether C-terminal provasopressin (copeptin) explains the prognostic importance of insulin growth factor binding protein-1 (IGFBP-1) in patients with myocardial infarction and type 2 diabetes.

RESEARCH DESIGN AND METHODS:

Copeptin and IGFBP-1 were analyzed in 393 patients participating in the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) 2 trial.

RESULTS:

Copeptin was associated with IGFBP-1 (Spearman rank correlation test, r = 0.53; P < 0.001). During follow-up there were 138 cardiovascular events (cardiovascular death, myocardial infarction, and stroke). In univariate Cox proportional hazard regression analyses both biomarkers were predictors of events: the hazard ratio for log copeptin was 1.59 (95% CI 1.41-1.81; P < 0.001) and for log IGFBP-1 was 1.49 (1.26-1.77; P < 0.001). In the final model, adjusting for age and renal function, copeptin was the only independent predictor (1.35 [1.16-1.57]; P < 0.001).

CONCLUSIONS:

Copeptin is an independent predictor of cardiovascular events and appears to at least partly explain the prognostic impact of IGFBP-1 in patients with type 2 diabetes and myocardial infarction. Copeptin may be a pathogenic factor to address to improve outcome in these patients.

• Authors: Linda G Mellbin, Lars Rydén, Kerstin Brismar, Nils G Morgenthaler, John Ohrvik, Sergiu B Catrina
• Journal: Diabetes care (Diabetes Care) Vol. 33 Issue 7 Pg. 1604-6 (Jul 2010) ISSN: 1935-5548 [Electronic] United States
• PMID: 20413521 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Glycopeptides
• IGFBP1 protein, human
• Insulin-Like Growth Factor Binding Protein 1
• copeptins

Topics

• Aged
• Death, Sudden, Cardiac (epidemiology)
• Diabetes Mellitus, Type 2 (metabolism, mortality)
• Female
• Follow-Up Studies
• Glycopeptides (blood)
• Humans
• Insulin-Like Growth Factor Binding Protein 1 (blood)
• Male
• Middle Aged
• Myocardial Infarction (metabolism, mortality)
• Predictive Value of Tests
• Prognathism
• Proportional Hazards Models
• Randomized Controlled Trials as Topic
• Risk Factors
• Stroke (metabolism, mortality)