Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Copeptin as a marker of outcome after cardiac arrest : A sub-study of the TTM trial

Düring, Joachim LU orcid ; Annborn, Martin LU ; Cronberg, Tobias LU ; Dankiewicz, Josef LU orcid ; Devaux, Yvan ; Hassager, Christian ; Horn, Janneke ; Kjaergaard, Jesper ; Kuiper, Michael and Nikoukhah, Homa Rafi , et al. (2020) In Critical Care 24(1).
Abstract

Background: Arginine vasopressin has complex actions in critically ill patients, involving vasoregulatory status, plasma volume, and cortisol levels. Copeptin, a surrogate marker for arginine vasopressin, has shown promising prognostic features in small observational studies and is used clinically for early rule out of acute coronary syndrome. The objective of this study was to explore the association between early measurements of copeptin, circulatory status, and short-term survival after out-of-hospital cardiac arrest. Methods: Serial blood samples were collected at 24, 48, and 72 h as part of the target temperature management at 33 °C versus 36 °C after cardiac arrest trial, an international multicenter randomized trial where... (More)

Background: Arginine vasopressin has complex actions in critically ill patients, involving vasoregulatory status, plasma volume, and cortisol levels. Copeptin, a surrogate marker for arginine vasopressin, has shown promising prognostic features in small observational studies and is used clinically for early rule out of acute coronary syndrome. The objective of this study was to explore the association between early measurements of copeptin, circulatory status, and short-term survival after out-of-hospital cardiac arrest. Methods: Serial blood samples were collected at 24, 48, and 72 h as part of the target temperature management at 33 °C versus 36 °C after cardiac arrest trial, an international multicenter randomized trial where unconscious survivors after out-of-hospital cardiac arrest were allocated to an intervention of 33 or 36 °C for 24 h. Primary outcome was 30-day survival with secondary endpoints circulatory cause of death and cardiovascular deterioration composite; in addition, we examined the correlation with extended the cardiovascular sequential organ failure assessment (eCvSOFA) score. Results: Six hundred ninety patients were included in the analyses, of whom 203 (30.3%) developed cardiovascular deterioration within 24 h, and 273 (39.6%) died within 30 days. Copeptin measured at 24 h was found to be independently associated with 30-day survival, hazard ratio 1.17 [1.06-1.28], p = 0.001; circulatory cause of death, odds ratio 1.03 [1.01-1.04], p = 0.001; and cardiovascular deterioration composite, odds ratio of 1.05 [1.02-1.08], p < 0.001. Copeptin at 24 h was correlated with eCvSOFA score with rho 0.19 [0.12-0.27], p < 0.001. Conclusion: Copeptin is an independent marker of severity of the post cardiac arrest syndrome, partially related to circulatory failure. Trial registration: Clinical Trials, NCT01020916. Registered November 26, 2009.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arginine vasopressin, AVP protein human, Biomarkers, Copeptin, Critical illness, Humans, Out-of hospital cardiac arrest, Prognosis, Survivors
in
Critical Care
volume
24
issue
1
article number
185
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85084107249
  • pmid:32345356
ISSN
1364-8535
DOI
10.1186/s13054-020-02904-8
language
English
LU publication?
yes
id
0a6f3b5a-5724-45e4-b08a-40e25e184df6
date added to LUP
2020-05-19 12:57:33
date last changed
2024-05-01 09:56:41
@article{0a6f3b5a-5724-45e4-b08a-40e25e184df6,
  abstract     = {{<p>Background: Arginine vasopressin has complex actions in critically ill patients, involving vasoregulatory status, plasma volume, and cortisol levels. Copeptin, a surrogate marker for arginine vasopressin, has shown promising prognostic features in small observational studies and is used clinically for early rule out of acute coronary syndrome. The objective of this study was to explore the association between early measurements of copeptin, circulatory status, and short-term survival after out-of-hospital cardiac arrest. Methods: Serial blood samples were collected at 24, 48, and 72 h as part of the target temperature management at 33 °C versus 36 °C after cardiac arrest trial, an international multicenter randomized trial where unconscious survivors after out-of-hospital cardiac arrest were allocated to an intervention of 33 or 36 °C for 24 h. Primary outcome was 30-day survival with secondary endpoints circulatory cause of death and cardiovascular deterioration composite; in addition, we examined the correlation with extended the cardiovascular sequential organ failure assessment (eCvSOFA) score. Results: Six hundred ninety patients were included in the analyses, of whom 203 (30.3%) developed cardiovascular deterioration within 24 h, and 273 (39.6%) died within 30 days. Copeptin measured at 24 h was found to be independently associated with 30-day survival, hazard ratio 1.17 [1.06-1.28], p = 0.001; circulatory cause of death, odds ratio 1.03 [1.01-1.04], p = 0.001; and cardiovascular deterioration composite, odds ratio of 1.05 [1.02-1.08], p &lt; 0.001. Copeptin at 24 h was correlated with eCvSOFA score with rho 0.19 [0.12-0.27], p &lt; 0.001. Conclusion: Copeptin is an independent marker of severity of the post cardiac arrest syndrome, partially related to circulatory failure. Trial registration: Clinical Trials, NCT01020916. Registered November 26, 2009.</p>}},
  author       = {{Düring, Joachim and Annborn, Martin and Cronberg, Tobias and Dankiewicz, Josef and Devaux, Yvan and Hassager, Christian and Horn, Janneke and Kjaergaard, Jesper and Kuiper, Michael and Nikoukhah, Homa Rafi and Stammet, Pascal and Undén, Johan and Wanscher, Michael Jaeger and Wise, Matt and Friberg, Hans and Nielsen, Niklas}},
  issn         = {{1364-8535}},
  keywords     = {{Arginine vasopressin; AVP protein human; Biomarkers; Copeptin; Critical illness; Humans; Out-of hospital cardiac arrest; Prognosis; Survivors}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Critical Care}},
  title        = {{Copeptin as a marker of outcome after cardiac arrest : A sub-study of the TTM trial}},
  url          = {{http://dx.doi.org/10.1186/s13054-020-02904-8}},
  doi          = {{10.1186/s13054-020-02904-8}},
  volume       = {{24}},
  year         = {{2020}},
}