Wen-Jun Tu1, Guo-Zhao Ma1, Ying Ni1, Xia-Sheng Hu1, Ding-Zhen Luo1, Xian-Wei Zeng2, Qiang Liu2, Tingting Xu1, Lie Yu1, Boshui Wu1. 1. From the Institute of Radiation Medicine (W.-J.T., Q.L.), China Academy of Medical Science and Peking Union Medical College, Tianjin; Department of Neurology (W.-J.T., X.-S.H.), China Rehabilitation Researcher Center, Beijing; Department of Neurology (G.-Z.M., D.-Z.L.), Shandong Provincial Hospital of Shandong University, Jinan; Department of Neurosurgery (Y.N., X.-W.Z., T.X.), Affiliated Hospital of Weifang Medical College; Department of Emergency (L.Y.), Four Affiliated Hospital of Harbin Medical University; and Department of Neurology (B.W.), Second Affiliated Hospital of Jilin University, Changchun, China. 2. From the Institute of Radiation Medicine (W.-J.T., Q.L.), China Academy of Medical Science and Peking Union Medical College, Tianjin; Department of Neurology (W.-J.T., X.-S.H.), China Rehabilitation Researcher Center, Beijing; Department of Neurology (G.-Z.M., D.-Z.L.), Shandong Provincial Hospital of Shandong University, Jinan; Department of Neurosurgery (Y.N., X.-W.Z., T.X.), Affiliated Hospital of Weifang Medical College; Department of Emergency (L.Y.), Four Affiliated Hospital of Harbin Medical University; and Department of Neurology (B.W.), Second Affiliated Hospital of Jilin University, Changchun, China. wfzwxin@126.com liuqiang_cams@163.com.
Abstract
OBJECTIVE: To evaluate long-term mortality in patients with acute ischemic stroke (AIS) by exploring the correlation between death and plasma concentrations of copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in a cohort study. METHODS: In a prospective, multicenter observational study of 4,215 patients with AIS, copeptin and NT-proBNP levels were measured with a standardized method when patients were admitted to hospital. The primary endpoint was all-cause mortality or cardiovascular disease (CVD) mortality within 1 year. RESULTS: During a follow-up period, 906 patients (20.1%, 95% confidence interval [CI] 18.9-21.2) died, including 589 cases of CVD mortality (13.1%, 95% CI 12.1-14.0). With the use of a multivariate analysis, both markers were found to have prognostic value in the same model (CVD mortality: odds ratio [OR] for fourth quartile of copeptin and NT-proBNP 1.68 and 2.58, 95% CI 1.22-2.49 and 1.76-4.05, respectively; all-cause mortality: OR for fourth quartile of copeptin and NT-proBNP 1.48 and 2.47, 95% CI 1.22-2.03 and 1.68-3.95, respectively). In a receiver operating characteristics analysis of CVD mortality, the area under the curve varied from 0.80 to 0.83 (95% CI 0.79-0.87) when the index of NT-proBNP was added and increased to 0.86 (95% CI 0.83-0.90) when both markers were added. CONCLUSIONS: Copeptin and NT-proBNP may be useful independent prognostic markers of all-cause or CVD mortality in Chinese patients with AIS.
OBJECTIVE: To evaluate long-term mortality in patients with acute ischemic stroke (AIS) by exploring the correlation between death and plasma concentrations of copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in a cohort study. METHODS: In a prospective, multicenter observational study of 4,215 patients with AIS, copeptin and NT-proBNP levels were measured with a standardized method when patients were admitted to hospital. The primary endpoint was all-cause mortality or cardiovascular disease (CVD) mortality within 1 year. RESULTS: During a follow-up period, 906 patients (20.1%, 95% confidence interval [CI] 18.9-21.2) died, including 589 cases of CVD mortality (13.1%, 95% CI 12.1-14.0). With the use of a multivariate analysis, both markers were found to have prognostic value in the same model (CVD mortality: odds ratio [OR] for fourth quartile of copeptin and NT-proBNP 1.68 and 2.58, 95% CI 1.22-2.49 and 1.76-4.05, respectively; all-cause mortality: OR for fourth quartile of copeptin and NT-proBNP 1.48 and 2.47, 95% CI 1.22-2.03 and 1.68-3.95, respectively). In a receiver operating characteristics analysis of CVD mortality, the area under the curve varied from 0.80 to 0.83 (95% CI 0.79-0.87) when the index of NT-proBNP was added and increased to 0.86 (95% CI 0.83-0.90) when both markers were added. CONCLUSIONS: Copeptin and NT-proBNP may be useful independent prognostic markers of all-cause or CVD mortality in Chinese patients with AIS.
Authors: D Leann Long; Boyi Guo; Leslie A McClure; Byron C Jaeger; Stephanie E Tison; George Howard; Suzanne E Judd; Virginia J Howard; Timothy B Plante; Neil A Zakai; Insu Koh; Katharine L Cheung; Mary Cushman Journal: Ann Epidemiol Date: 2021-11-03 Impact factor: 3.797