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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Copeptin and risk stratification in patients with acute dyspnea. | Potocki et al. Critical Care 2010 14 R213 http ccforum.eom content 14 6 R213 c CRITICAL CARE RESEARCH Open Access Copeptin and risk stratification in patients with acute dyspnea 1 2 2 1 2 2 Mihael Potocki Tobias Breidthardt Alexandra Mueller Tobias Reichlin Thenral Socrates Nisha Arenja Miriam Reiter2 Nils G Morgenthaler 3 Andreas Bergmann 3 Markus Noveanu 1 Peter T Buser 1 Christian Mueller 2 Abstract Introduction The identification of patients at highest risk for adverse outcome who are presenting with acute dyspnea to the emergency department remains a challenge. This study investigates the prognostic value of Copeptin the C-terminal part of the vasopressin prohormone alone and combined to N-terminal pro B-type natriuretic peptide NT-proBNP in patients with acute dyspnea. Methods We conducted a prospective observational cohort study in the emergency department of a university hospital and enrolled 287 patients with acute dyspnea. Results Copeptin levels were elevated in non-survivors n 29 compared to survivors at 30 days 108 pmol l interquartile range IQR 37 to 197 pmol l vs. 18 pmol l IQR 7 to 43 pmol l P 0.0001 . The areas under the receiver operating characteristic curve AUC to predict 30-day mortality were 0.83 95 confidence interval CI 0.76 to 0.90 0.76 95 CI 0.67 to 0.84 and 0.63 95 CI 0.53 to 0.74 for Copeptin NT-proBNP and BNP respectively Copeptin vs. NTproBNP P 0.21 Copeptin vs. BNP P 0.002 . When adjusted for common cardiovascular risk factors and NT-proBNP Copeptin was the strongest independent predictor for short-term mortality in all patients HR 3.88 1.94 to 7.77 P 0.001 and especially in patients with acute decompensated heart failure ADHF HR 5.99 2.55 to 14.07 P 0.0001 . With the inclusion of Copeptin to the adjusted model including NTproBNP the net reclassification improvement NRI was 0.37 P 0.001 . An additional 30 of those who experienced events were reclassified as high risk and an additional 26 without events were reclassified as low risk. .
