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GW24-e3071 Comparative evaluation of copeptin and NT-proBNP in Patients with severe Acute Decompensated Heart Failure
  1. Zhang Dongying,
  2. Jia Jun,
  3. Chen Jia,
  4. Qin Shu
  1. Department of Cardiology, First Affiliated Hospital of Chongqing Medical University

Abstract

Objectives This study compared the prognostic value of a marker, C-terminal part of the arginine vasopressin prohormone (Copeptin), with N-terminal B-type natriuretic peptide (NT-proBNP) in patients with severe acute decompensated heart failure.

Methods We conducted a prospective, observational cohort study in a tertiary care hospital and enrolled 129 patients with sever acute decompensated heart failure (NYHA Class III/IV). Clinicians were blinded to investigational markers except NT-proBNP, and the study participants were followed for 90-day. The end point was a composite of cardiovascular death or re-hospitalisation due to decompensated heart failure.

Results Of the 129 patients enrolled, 47 reached end point and 82 in stable condition during follow-up. In patients in stable condition the NP-proBNP and copeptin levels were 3275 (1008.8–8827.0) pg/mL and 0.79 ± 0.30 ng/mL. In patients reach the adverse endpoint the two biomarkers levels were 6656 (2919.0–15701.0) pg/mL and 0.92 ± 0.31 ng/mL. For those two markers, values are significantly higher in adverse endpoint patients than in stable condition patients (P = 0.003, P = 0.022).

Receiver operating characteristic curve (ROC) curve analysis showed that the areas under curve (AUCs) for the prediction of 90-day adverse events were similar for copeptin 0.602 (SE, 0.052; 95% CI 0.499-0.705), NT-proBNP 0.659 (SE, 0.048; 95% CI 0.565-0.753) and their combination 0.670 (SE, 0.050; 95% CI 0.573-0.767). In survival analysis, Kaplan-Meier curve analyses showed that the predictive value of NT-proBNP for survival probability was superior (log-rank test for trend, P = 0.001) than copeptin (log-rank test for trend, P = 0.040). In multivariable Cox proportional-hazards regression analyses, increased NT-proBNP, copeptin plasma concentrations were significant independent predictors of adverse events.

Conclusions The study provides evidence that copeptin measurements have similar predictive properties compared with NT-proBNP determinations for 90-day adverse events in severe acute decompensated heart failure, and copeptin may not provide superior 90-day prediction compared to NT-proBNP.

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