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-  2019 

Copeptin and insulin

DOI: 10.1177/1479164118804451

Keywords: Copeptin,vasopressin,biomarkers,myocardial infarction,type 2 diabetes mellitus

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Abstract:

Copeptin and insulin-like growth factor binding protein-1 analysed at admission for a myocardial infarction in patients with type 2 diabetes mellitus predicts cardiovascular events. The present aim was to study the association between copeptin and insulin-like growth factor binding protein-1, the development of the levels over time, and if the predictive value remained when measured at hospital discharge and 3?months thereafter. Copeptin and insulin-like growth factor binding protein-1 were analysed in patients (median age?=?70, male?=?68%) with type 2 diabetes mellitus?+?myocardial infarction at admission (n?=?393), discharge (n?=?309) and 3?months later (n?=?288). The primary endpoint was cardiovascular event (cardiovascular death/non-fatal myocardial infarction/stroke) with the three time points as separate baselines. The median copeptin levels were 21.8?pmol/L at admission, 8.5?pmol/L at discharge and 8.4?pmol/L after 3?months, while insulin-like growth factor binding protein-1 levels continued to increase. There were significant correlations between the biomarkers at all occasions. During an average follow-up of 2.5?years, copeptin, but not insulin-like growth factor binding protein-1, predicted cardiovascular event at all occasions in unadjusted analyses. Copeptin remained as a predictor at discharge and after 3?months in the final multiple model (including: heart failure/age/creatinine clearance). The relationship between copeptin and insulin-like growth factor binding protein-1 during the initial phase of a myocardial infarction persisted in a less-stressful situation, and copeptin remained as a prognostic indicator at discharge and 3?months later

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