Cardiology Letters 2011, 20(4):311-317

Copeptin as novel and significant marker in the diagnostics and prognosis of acute cardiovascular diseases and hyponatremias

Hrnčiar J

Interná klinika FNsP F. D. Roosevelta v Banskej Bystrici, Slovenská republika

In contemporary clinical praxis copeptin, a C-terminal polypeptide of the prohormone molecule of arginine vasopressin (AVP) or the antidiuretic hormone (ADH), has proved to be (given the stability of its molecule) a timely and sensitive marker of acute myocardial infarction (AMI), congestive heart failure and cerebrovascular accident (CVA) where the V1 AVP receptors are pathogenetically more involved. The levels of copeptin and levels of troponin T in AMI even enable mortality prognosis of the disease. Normal levels of copeptin and troponin 4-6 hours after first symptoms appear rule out AMI and have a 99 percent negative predictive value. Copeptin is a less specific and sensitive marker in the differentiation of hyponatremia and SIADH (syndrome of inappropriate antidiuretic hormone hypersecretion), in which mainly V2 receptors are pathogenetically involved, than in cardiovascular diseases. Low levels of copeptin were detected only in cases of hyponatremia in primary polydipisia. Although the highest levels were present in hypovolemic hyponatremia, they overlapped in hypovolemic and dilution hyponatremia in individual patients, which made it difficult to differentiate these on the basis of copeptin levels. AVP and copeptin are the answer of the organism to any form of intensive stress.

Keywords: copeptin; marker of acute CVD; marker of intensity of stress and hyponatremias

Published: April 1, 2011  Show citation