The diagnostic value of serum copeptin levels in an acute pulmonary embolism
The diagnostic value of serum copeptin levels in an acute pulmonary embolism
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DOI：
10.5603/cj.a2015.0077
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发表时间：
2016-01-01
影响因子：
2.9
通讯作者：
Celik, Ahmet
中科院分区：
文献类型：
--
作者：
Kalkan, Ali Kemal;Ozturk, Derya;Celik, Ahmet
背景：急性肺栓塞（APE）是一种常见疾病，死亡率和发病率较高。在最近的研究中，和肽素的循环水平被证明在心力衰竭、急性心肌梗塞和肺动脉高压中升高，据报道是不良预后的独立预测因子。本研究的目的是探讨和肽素在 APE 诊断中的临床效用。 方法：本前瞻性研究纳入了 90 名因急性胸痛和/或呼吸困难而入院急诊并因怀疑 APE 接受肺计算机断层扫描血管造影 (CTA) 的连续患者。诊断为 APE 的患者定义为 APE (+) 组，其余肺部 CTA 结果正常的个体定义为 APE (-) 组。 结果：APE (+) 组的和肽素水平（7.76 +/- 4.4 vs. 3.81 +/- 1.34 ng/dL；p < 0.001）高于 APE (-) 组。和肽素与 B 型利钠肽 (r = 0.434，p < 0.001)、D-二聚体 (r = 0.315，p = 0.003) 和肌钙蛋白 I (r = 0.300，p = 0.004) 呈显着正相关，与动脉氧饱和度呈负相关 (r = -0.533，p < 0001)。当研究和肽素与右心室功能障碍参数的相关性时，它与三尖瓣环平面收缩期偏移呈显着负相关（r = -0.521，p < 0.001），与右心室与左心室比率呈正相关（r = 0.329，p = 0.024）。在调整其他风险参数后，在多变量分析中发现和肽素（OR 1.836，95% CI 1.171-2.878，p = 0.008）是 APE 的显着独立预测因子。结论：和肽素是一种有前途的新生物标志物，可用于支持进一步研究的需要并改善 APE 患者的诊断。
Background: Acute pulmonary embolism (APE) is a common disease which is associated with high mortality and morbidity. Circulating level of copeptin, which was demonstrated to be elevated in heart failure, acute myocardial infarction and pulmonary arterial hypertension, were reported to be independent predictors of poor outcome in recent studies. The aim of the present study was to investigate the clinical utility of copeptin in the diagnosis of APE.Methods: A total of 90 consecutive patients, admitted to emergency service due to acute chest pain and/or dyspnea and who underwent pulmonary computerized tomography angiography (CTA) due to suspicion of APE, were included in this prospective study. The patients diagnosed with APE were defined as APE (+) group and the remaining individuals with normal pulmonary CTA result were defined as APE (-) group.Results: Copeptin levels (7.76 +/- 4.4 vs. 3.81 +/- 1.34 ng/dL; p < 0.001) were higher in the APE (+) group as compared to the APE (-) group. Copeptin was significantly positively correlated with B-type natriuretic peptide (r = 0.434, p < 0.001), D-dimer (r = 0.315, p = 0.003) and troponin I (r = 0.300, p = 0.004) and inversely correlated with arterial oxygen saturations (r = -0.533, p < 0001). When the correlation of copeptin with right ventricular dysfunction parameters was investigated, it was significantly inversely correlated with the tricuspid annular plane systolic excursion (r = -0.521, p < 0.001) and positively correlated with right to left ventricle ratio (r = 0.329, p = 0.024). Copeptin (OR 1.836, 95% CI 1.171-2.878, p = 0.008) was found as a significant independent predictor of APE in a multivariate analysis, after adjusting for other risk parameters.Conclusions: Copeptin is a promising new biomarker, which may be used to support the need for further investigations and to improve the diagnosis of patients with APE.