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Copeptin predicts 10-year all-cause mortality in community patients: a 10-year prospective cohort study

  • Jonas Odermatt , Rebekka Bolliger , Lara Hersberger , Manuel Ottiger , Mirjam Christ-Crain , Matthias Briel , Heiner C. Bucher , Beat Mueller and Philipp Schuetz EMAIL logo
Published/Copyright: May 12, 2016
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 10

Abstract

Background:

Copeptin, the C-terminal part of the arginine vasopressin (AVP) precursor peptide, is secreted in response to stress and correlates with adverse clinical outcomes in the acute-care hospital setting. There are no comprehensive data regarding its prognostic value in the community. We evaluated associations of copeptin levels with 10-year mortality in patients visiting their general practitioner (GP) for a respiratory infection included in a previous trial.

Methods:

This is a post hoc analysis including data from 359 patients included in the PARTI trial. Copeptin was measured in batch-analysis on admission and after 7 days. We calculated Cox regression models and area under the receiver operating characteristic curve (AUC) to assess an association of copeptin with mortality and adverse outcome. Follow-up data were collected by GP, patient and relative tracing through phone interviews 10 years after trial inclusion.

Results:

After a median follow-up of 10.0 years, mortality was 9.8%. Median admission copeptin levels (pmol/L) were significantly elevated in non-survivors compared to survivors (13.8, IQR 5.9–27.8; vs. 6.3 IQR 4.1–11.5; p<0.001). Admission copeptin levels were associated with 10-year all-cause mortality [age-adjusted hazard ratio 1.7 (95% CI, 1.2–2.5); p<0.001, AUC 0.68]. Results were similar for discharge copeptin levels. Copeptin also predicted adverse outcomes defined as death, pulmonary embolism and major adverse cardiac and cerebrovascular events.

Conclusions:

In a sample of community-dwelling patients visiting their GP for a respiratory infection, copeptin levels were associated with 10-year all-cause mortality. In conjunction with traditional risk factors, this marker may help to better direct preventive measures in this population.

Keywords: biomarker; copeptin; primary care; respiratory tract infection; 10-year mortality

Funding source: National Science Foundation

Award Identifier / Grant number: 3300C0-107772

Funding statement: This investigator-initiated PARTI trial was sponsored by a grant from the Swiss National Science Foundation (3300C0-107772) and by the Association for the Promotion of Science and Postgraduate Training of the University Hospital Basel. B.R.A.H.M.S AG provided assay and kit material related to the study. Dr. Schuetz and Dr. Christ-Crain were supported by funds from the Freiwillige Akademische Gesellschaft, the Department of Endocrinology, Diabetology and Clinical Nutrition, and the Department of Clinical Chemistry, all Basel, Switzerland. Drs. Christ-Crain, Mueller, and Schuetz, received support from B.R.A.H.M.S to attend meetings and fulfilled speaking engagements. Drs. Schuetz, Christ-Crain and Mueller received support from bioMérieux to attend meetings and fulfilled speaking engagements. Dr. Mueller has served as a consultant and received research support from B.R.A.H.M.S and bioMérieux. All other authors declare that the answer to the questions on the competing interest form is all “No” and therefore have nothing to declare.

Acknowledgments:

We are grateful to the physicians, their staffs and patients who participated in the PARTI trial and the follow-up data collection. We would also like to thank the staff of the central laboratory of the University Hospital Basel for their assistance and technical support.

  1. Author contributions: Mr. Odermatt and Ms. Bolliger contributed equally to this study. Mr. Odermatt, Ms. Bolliger and Dr. Schuetz had full access to all of the data in the study and take responsibility for the integrity of the data and performed the statistical work, and drafted the manuscript. All authors helped to interpret the findings, read and revised the manuscript critically for important intellectual content, and approved the final version of the manuscript.

  2. Research funding: This investigator-initiated PARTI trial was sponsored by a grant from the Swiss National Science Foundation (3300C0-107772) and by the Association for the Promotion of Science and Postgraduate Training of the University Hospital Basel. B.R.A.H.M.S AG provided assay and kit material related to the study. Dr. Schuetz and Dr. Christ-Crain were supported by funds from the Freiwillige Akademische Gesellschaft, the Department of Endocrinology, Diabetology and Clinical Nutrition, and the Department of Clinical Chemistry, all Basel, Switzerland. Drs. Christ-Crain, Mueller, and Schuetz, received support from B.R.A.H.M.S to attend meetings and fulfilled speaking engagements. Drs. Schuetz, Christ-Crain and Mueller received support from bioMérieux to attend meetings and fulfilled speaking engagements. Dr. Mueller has served as a consultant and received research support from B.R.A.H.M.S and bioMérieux. All other authors declare that the answer to the questions on the competing interest form is all “No” and therefore have nothing to declare.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplemental Material:

The online version of this article (DOI: 10.1515/cclm-2016-0151) offers supplementary material, available to authorized users.

Received: 2016-2-23
Accepted: 2016-4-6
Published Online: 2016-5-12
Published in Print: 2016-10-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2016-0151
Keywords for this article
biomarker; copeptin; primary care; respiratory tract infection; 10-year mortality

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Serum myoglobin immunoassays: obsolete or still clinically useful?
  4. Reviews
  5. Kounis syndrome: an update on epidemiology, pathogenesis, diagnosis and therapeutic management
  6. What do we know about homocysteine and exercise? A review from the literature
  7. Mini Review
  8. Osteocalcin as a potential risk biomarker for cardiovascular and metabolic diseases
  9. Opinion Paper
  10. Statistical approach for optimization of external quality assurance (EQA) studies of molecular and serological viral diagnostics
  11. EFLM Article
  12. Sample collections from healthy volunteers for biological variation estimates’ update: a new project undertaken by the Working Group on Biological Variation established by the European Federation of Clinical Chemistry and Laboratory Medicine
  13. General Clinical Chemistry and Laboratory Medicine
  14. Analyte stability during the total testing process: studies of vitamins A, D and E by LC-MS/MS
  15. Improvement in the predictive ability of the Intermountain Mortality Risk Score by adding routinely collected laboratory tests such as albumin, bilirubin, and white cell differential count
  16. Cystatin C provides a better estimate of the effect of glomerular filtration rate on serum human epididymis protein 4 concentrations
  17. Verification of the harmonization of human epididymis protein 4 assays
  18. Clinical utility of urinary liver-type fatty acid binding protein measured by latex-enhanced turbidimetric immunoassay in chronic kidney disease
  19. Comparison of three analytical platforms for quantification of the neurofilament light chain in blood samples: ELISA, electrochemiluminescence immunoassay and Simoa
  20. Reference Values and Biological Variations
  21. Distribution of antiphospholipid antibodies in a large population-based German cohort
  22. Cardiovascular Diseases
  23. Serum protein S100 as marker of postoperative delirium after off-pump coronary artery bypass surgery: secondary analysis of two prospective randomized controlled trials
  24. Infectious Diseases
  25. Copeptin predicts 10-year all-cause mortality in community patients: a 10-year prospective cohort study
  26. Clinical and laboratory findings in the diagnosis of right lower quadrant abdominal pain: outcome analysis of the APPAC trial
  27. Letters to the Editor
  28. Why a new algorithm using high-sensitivity cardiac troponins for the rapid rule-out of NSTEMI is not adapted to routine practice
  29. Optimal collection tubes for plasma glucose determination: confusion reigns supreme
  30. Long-term stability of serum samples positive for carbohydrate deficient transferrin (CDT) routinely stored at −20 °C
  31. Seasonal variations in plasma free metanephrine concentrations are not evident in the West of Ireland
  32. Potential errors in the determination of urinary ammonium by formol titration
  33. Interference by biological anti-cancer drugs in electrophoretic and immunofixation techniques
  34. A point mutation in the thiopurine S-methyltransferase gene that led to exon 5 deletion in the transcribed mRNA
  35. Detection of the heterozygote of hemoglobin Constant Spring by α-thalassemia immunochromatographic strip test
  36. Automated CH50 liposome-based immunoassay: consideration in dilution and validation of reference interval
  37. Theranos phenomenon – Part 5: Theranos’ presentation at the American Association for Clinical Chemistry Annual Conference 2016
  38. Congress Abstracts
  39. 58th National Congress of the Hungarian Society of Laboratory Medicine
  40. The 4th Joint EFLM-UEMS Congress “Laboratory Medicine at the Clinical Interface” Warsaw, Poland, 21th–24th September, 2016
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