Copeptin for the prediction of recurrent cerebrovascular events after transient ischemic attack: results from the CoRisk study.

De Marchis, Gian Marco; Weck, Anja; Audebert, Heinrich; Benik, Steffen; Foerch, Christian; Buhl, Daniela; Schuetz, Philipp; Jung, Simon; Seiler, Marleen; Morgenthaler, Nils G; Mattle, Heinrich P.; Mueller, Beat; Christ-Crain, Mirjam; Arnold, Marcel; Katan, Mira (2014). Copeptin for the prediction of recurrent cerebrovascular events after transient ischemic attack: results from the CoRisk study. Stroke, 45(10), pp. 2918-2923. Lippincott Williams & Wilkins 10.1161/STROKEAHA.114.005584

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BACKGROUND AND PURPOSE Copeptin has been associated with recurrent cerebrovascular events after transient ischemic attack (TIA). In an independent cohort, we evaluated copeptin for the prediction of recurrent cerebrovascular events within 3 months after TIA and assessed the incremental value of copeptin compared with the ABCD2 (age, blood, clinical features of TIA, duration of symptoms, presence of diabetes mellitus) and ABCD3-I (ABCD2, dual TIA [the presence of ≥2 TIA symptoms within 7 days], imaging [the presence of abnormal findings on neuroimaging]) scores. METHODS This prospective, multicenter cohort study was conducted at 3 tertiary Stroke Centers in Switzerland and Germany. RESULTS From March 2009 through April 2011, we included 302 patients with TIA admitted within 24 hours from symptom onset. Of 28 patients with a recurrent cerebrovascular event within 3 months (stroke or TIA), 11 patients had a stroke. Although the association of copeptin with recurrent cerebrovascular events was not significant, the association with stroke alone as end point was significant. After adjusting for the ABCD2 score, a 10-fold increase in copeptin levels was associated with an odds ratio for stroke of 3.39 (95% confidence interval, 1.28-8.96; P=0.01). After addition of copeptin to the ABCD2 score, the area under the curve of the ABCD2 score improved from 0.60 (95% confidence interval, 0.46-0.74) to 0.74 (95% confidence interval, 0.60-0.88, P=0.02). In patients with MRI (n=223), the area under the curve of the ABCD3-I score increased in similar magnitude, although not significantly. Based on copeptin, 31.2% of patients were correctly reclassified across the risk categories of the ABCD2 score (net reclassification improvement; P=0.17). CONCLUSIONS Copeptin improved the prognostic value of the ABCD2 score for the prediction of stroke but not TIA, and it may help clinicians in refining risk stratification for patients with TIA. CLINICAL TRIAL REGISTRATION URL http://www.clinicaltrials.gov. Unique identifier: NCT00878813.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

De Marchis, Gian Marco; Weck, Anja; Jung, Simon; Mattle, Heinrich and Arnold, Marcel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0039-2499

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Valentina Rossetti

Date Deposited:

18 Feb 2015 14:41

Last Modified:

29 Oct 2015 11:59

Publisher DOI:

10.1161/STROKEAHA.114.005584

PubMed ID:

25169950

Additional Information:

Arnold M und Katan M are equally contributing authors

Uncontrolled Keywords:

biomarker, copeptin, prediction, stroke, transient ischemic attack

BORIS DOI:

10.7892/boris.63380

URI:

https://boris.unibe.ch/id/eprint/63380

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