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Copeptin is associated with mortality in elderly people

Copeptin is associated with mortality in elderly people

Title: Copeptin is associated with mortality in elderly people
Author: Smaradottir, Maria Isabel
Andersen, Karl
Gudnason, Vilmundur   orcid.org/0000-0001-5696-0084
Näsman, Per
Rydén, Lars
Mellbin, Linda Garcia
Date: 2021-07
Language: English
Scope: 116595
Department: Faculty of Medicine
Series: European Journal of Clinical Investigation; 51(7)
ISSN: 0014-2972
DOI: 10.1111/eci.13516
Subject: Hormónar; Dánartíðni; Amínósýrur; Hjartadrep; copeptin; cortisol; myocardial infarction; NTproBNP; unknown myocardial infarction; vasopressin; Heart Failure/epidemiology; Recurrence; Cardiovascular Diseases/mortality; Prognosis; Humans; Mortality; Proportional Hazards Models; Male; Hydrocortisone/blood; Glycopeptides/blood; Myocardial Infarction/blood; Aged, 80 and over; Female; Stroke/epidemiology; Aged; Peptide Fragments/blood; Myocardial Revascularization/statistics & numerical data; Natriuretic Peptide, Brain/blood; Biochemistry; Clinical Biochemistry
URI: https://hdl.handle.net/20.500.11815/3071

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Smaradottir , M I , Andersen , K , Gudnason , V , Näsman , P , Rydén , L & Mellbin , L G 2021 , ' Copeptin is associated with mortality in elderly people ' , European Journal of Clinical Investigation , vol. 51 , no. 7 , e13516 , pp. e13516 . https://doi.org/10.1111/eci.13516


BACKGROUND: Elevated copeptin, a marker for vasopressin release, has been associated with impaired prognosis in acute myocardial infarction (MI). The aim was to investigate whether this association extends beyond the acute phase and whether it is related to markers of stress (cortisol) and heart failure (NTproBNP). METHODS: Copeptin, cortisol and NTproBNP were measured in 926 participants (age: 76.0; male: 48.5%) in the ICELAND MI study whereof 246 had a previous MI (91 recognizable (RMI) and 155 previously unrecognizable (UMI) detected by cardiac magnetic resonance imaging). The primary endpoint was cardiovascular events (CVEs), and secondary endpoints were total mortality, heart failure and MI (median follow-up was 9.1 years). The relation between copeptin and prognosis was assessed with the Cox proportional hazard regression (unadjusted, adjusted for cortisol and NTproBNP, respectively, and a multiple model: copeptin, cortisol, NTproBNP, age, sex, serum creatinine, heart failure). RESULTS: Copeptin was higher in participants with MI (8.9 vs. 6.4 pmol/L; P < .01), with no difference between RMI vs. UMI. Increased copeptin correlated with evening cortisol (r = .11; P < .01) and NTproBNP (r = .07; P = .04). Copeptin was associated with CVE and total mortality after adjusting for cortisol and NTproBNP separately, and remained significantly associated with total mortality in the multiple model. CONCLUSIONS: Copeptin was higher in subjects with previous MI regardless whether previously recognized or not. Copeptin correlated weakly with cortisol and NTproBNP, and was independently associated with total mortality. This indicates that the prognostic implications of copeptin are not only mediated by heart failure or stress, supporting the assumption that copeptin is a marker of general vulnerability.


© 2021 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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