Serum copeptin level as a prognostic marker for acute ischemic cerebrovascular stroke and cerebral hemorrhage

Objective To assess the predictive utility of serum copeptin concerning the 30-day mortality among patients presenting with ischemic stroke (IS) or hemorrhagic stroke (HS) acute cerebrovascular stroke. Besides, we aimed to evaluate whether serum copeptin has a role in discriminating between HS and IS. Background Since its discovery in early 1970s, copeptin has emerged as an effective predictive marker with high potentials of wide clinical applications due to its stability and robust measure. Serum copeptin can reflect the vasopressogenics in a practical way. Patients and methods We performed this prospective study on patients with either IS or HS, as indicated by clinical signs and computed tomography. The serum copeptin level was assessed by sandwich immunoassay at admission. All patients were followed up for 30 days after admission. Results Nonsurvivors with acute cerebrovascular stroke exhibited a significantly higher copeptin level than the survivors’ group (P=0.038). Besides, patients with HS exhibited a significantly higher copeptin level than the patients with IS (P=0.042). Copeptin showed good sensitivity (70.6%) and specificity (56.5%) at a cutoff value of 48.8 pmol/l to predict mortality in the whole studied population. Conclusions Serum copeptin is a promising prognostic tool for the prediction of short-term mortality in patients with acute cerebrovascular stroke. Besides, the serum copeptin has a fair diagnostic accuracy for the differentiation of IS and HS.