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Copeptin, C-reactive protein, and procalcitonin as prognostic biomarkers in acute exacerbation of COPD.

Abstract：

BACKGROUND:A novel approach to estimate the severity of COPD exacerbation and predict its outcome is the use of biomarkers. We assessed circulating levels of copeptin, the precursor of vasopressin, C-reactive protein (CRP), and procalcitonin as potential prognostic parameters for in-hospital and long-term outcomes in patients with acute exacerbation of COPD (AECOPD) requiring hospitalization. METHODS:Data of 167 patients (mean age, 70 years; mean FEV(1), 39.9 +/- 16.9 of predicted [+/- SD]) presenting to the emergency department due to AECOPD were analyzed. Patients were evaluated based on clinical, laboratory, and lung function parameters on hospital admission, at 14 days, and at 6 months. RESULTS:Plasma levels of all three biomarkers were elevated during the acute exacerbation (p < 0.001), but levels at 14 days and 6 months were similar (p = not significant). CRP was significantly higher in patients presenting with Anthonisen type I exacerbation (p = 0.003). In contrast to CRP and procalcitonin, copeptin on hospital admission was associated with a prolonged hospital stay (p = 0.002) and long-term clinical failure (p < 0.0001). Only copeptin was predictive for long-term clinical failure independent of age, comorbidity, hypoxemia, and lung functional impairment in multivariate analysis (p = 0.005). The combination of copeptin and previous hospitalization for COPD increased the risk of poor outcome (p < 0.0001). Long-term clinical failure was observed in 11% of cases with copeptin < 40 pmol/L and no history of hospitalization, as compared to 73% of patients with copeptin >/= 40 pmol/L and a history of hospitalization (p < 0.0001). CONCLUSIONS:We suggest copeptin as a prognostic marker for short-term and long-term prognoses in patients with AECOPD requiring hospitalization.

journal_name

Chest

journal_title

Chest

authors

Stolz D,Christ-Crain M,Morgenthaler NG,Leuppi J,Miedinger D,Bingisser R,Müller C,Struck J,Müller B,Tamm M

doi

10.1378/chest.06-2336

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

1058-67

issue

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)49032-4

journal_volume

131

pub_type

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Copeptin, C-reactive protein, and procalcitonin as prognostic biomarkers in acute exacerbation of COPD.