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Additive prognostic value of copeptin and NT-proBNP in patients with acute heart failure

Session Poster Session 3

Speaker Konstantin A Krychtiuk

Event : Acute Cardiovascular Care 2016

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure
  • Session type : Poster Session

Authors : KA Krychtiuk (Vienna,AT), M Lenz (Vienna,AT), L Chi (Vienna,AT), C Zhang (Vienna,AT), MC Honeder (Vienna,AT), G Maurer (Vienna,AT), K Huber (Vienna,AT), J Wojta (Vienna,AT), G Heinz (Vienna,AT), WS Speidl (Vienna,AT)

Authors:
KA Krychtiuk1 , M Lenz1 , L Chi1 , C Zhang1 , MC Honeder1 , G Maurer1 , K Huber2 , J Wojta1 , G Heinz1 , WS Speidl1 , 1Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology - Vienna - Austria , 2Wilhelminen Hospital, 3rd Department of Internal Medicine, Cardiology and Emergency Medicine - Vienna - Austria ,

Citation:
European Heart Journal Supplement ( 2010 ) 12 ( Supplement F ), F210

Background: Patients suffering from acute heart failure (AHF) requiring admission to an intensive care unit (ICU) have a poor prognosis. The C-terminal portion of provasopressin (Copeptin) represents a surrogate parameter for vasopressin, has been described as a marker for endogenous stress. Besides its use as a rule-out marker in patients with NSTE-ACS it has been described as a prognostic biomarker in patients with acute illness.
Purpose: The aim of this study was to analyze whether admission levels of copeptin are associated with 30-day survival in patients with AHF admitted to a cardiac ICU.
Methods: We included 90 consecutive patients with AHF admitted to our cardiovascular ICU (33% with cardiogenic shock, 21% with acutely decompensated HF and 46% of patients suffered from AHF after cardiac arrest). Blood was taken at admission, mtDNA levels were measured by real-time PCR while copeptin was measured by an automated sandwich immunofluorescent assay.
Results: Mean age was 62.1 ± 16.0, 76.7% of patients were male and median NT-proBNP levels were 4986 (1525 – 23842) pg/mL. 30-day survival was 64.4%. Non-survivors had significantly higher values of both copeptin (139.8 (44.7-311.2) pmol/L vs. 31.4 (17-77.1) pmol/L, p<0.001) and NT-proBNP (23718 (2981 – >35000) pg/mL vs. 3262 (1000.3 – 8212.3) pg/mL). Interestingly, copeptin and NT-proBNP showed additive prognostic value. When patients were stratified according to the median of NT-proBNP and copeptin, those with both copeptin and NT-proBNP levels above the median had the highest risk of dying (HR 4.6, p=0.003).
Conclusion: In a cohort of patients with AHF requiring ICU admission, copeptin levels measured at admission added prognostic value to NT-proBNP levels.

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