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Copeptin is an independent predictor of diabetic heart disease and death
Sofia Enhörning1, Bo Hedblad1, Peter M Nilsson1
1Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
Insights
High copeptin levels predict heart disease and death, but only in individuals with diabetes. This finding highlights copeptin as a potential prognostic marker and therapeutic target for diabetic heart conditions.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Biomarker Research
Background:
- Previous research linked high copeptin to diabetes mellitus, obesity, and albuminuria.
- Copeptin is known to predict cardiovascular events post-myocardial infarction in diabetic patients.
- The association of copeptin with heart disease and death in non-diabetic individuals was previously unknown.
Purpose of the Study:
- To investigate whether plasma copeptin predicts heart disease and death.
- To determine if copeptin's predictive ability differs between diabetic and non-diabetic individuals.
Main Methods:
- Plasma copeptin levels were analyzed in relation to a combined endpoint of coronary artery disease, heart failure, and death.
- The study included both diabetic (n=895) and non-diabetic (n=4187) participants from the Malmö Diet and Cancer Study-Cardiovascular cohort.
- Statistical analyses adjusted for conventional risk factors and prevalent cardiovascular disease.
Main Results:
- A significant interaction between copeptin and diabetes was observed for the combined endpoint (P=.006).
- In diabetic individuals, copeptin independently predicted the combined endpoint, coronary artery disease, heart failure, and death.
- In contrast, copeptin showed no association with these endpoints in non-diabetic individuals.
Conclusions:
- Plasma copeptin is a significant predictor of heart disease and death specifically in patients with diabetes.
- These findings suggest the vasopressin system, indicated by copeptin, as a potential prognostic marker and therapeutic target for diabetic heart disease.
- Further research into copeptin's role could lead to improved management strategies for diabetic cardiovascular complications.
Background:
We previously discovered that high copeptin is associated with incidence of diabetes mellitus (diabetes), abdominal obesity, and albuminuria. Furthermore, copeptin predicts cardiovascular events after myocardial infarction in diabetic patients, but whether it is associated with heart disease and death in individuals without diabetes and prevalent cardiovascular disease is unknown. In this study, we aim to test whether plasma copeptin (copeptin), the C-terminal fragment of arginine vasopressin prohormone, predicts heart disease and death differentially in diabetic and nondiabetic individuals.
Methods:
We related plasma copeptin to a combined end point composed of coronary artery disease (CAD), heart failure (HF), and death in diabetes (n = 895) and nondiabetes (n = 4187) individuals of the Malmö Diet and Cancer Study-Cardiovascular cohort.
Results:
Copeptin significantly interacted with diabetes regarding the combined end point (P = .006). In diabetic individuals, copeptin predicted the combined end point (hazard ratio [HR] 1.32 per SD, 95% CI 1.10-1.58, P = .003) after adjustment for conventional risk factors, prevalent HF and CAD, and remained significant after additional adjustment for either fasting glucose (P = .02) or hemoglobin A1c (P = .02). Furthermore, in diabetic individuals, copeptin predicted CAD (HR 1.33 per SD, 95% CI 1.04-1.69, P = .02), HF (HR 1.62 per SD, 95% CI 1.09-2.41, P = .02), and death (HR 1.32 per SD, 95% CI 1.04-1.68, P = .02). Interestingly, among nondiabetic individuals, copeptin was not associated with any of the end points.
Conclusions:
Copeptin predicted heart disease and death, specifically in diabetes patients, suggesting copeptin and the vasopressin system as a prognostic marker and therapeutic target for diabetic heart disease and death.
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