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Published on: September 15, 2017
The cardiovascular markers copeptin and high-sensitive C-reactive protein decrease following specific therapy for
Hanna Remde1, Anna Dietz, Rebecca Emeny
1aClinical Endocrinology, Charité Campus Mitte, Charité University Medicine Berlin, Berlin bMedizinische Klinik und Poliklinik IV, University Hospital Munich, Munich cHelmholtz Zentrum München, Institute of Epidemiology II, German Research Center for Environmental Health, Neuherberg dGerman Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich eEndocrinology in Charlottenburg, Berlin, Germany.
Insights
Copeptin and high-sensitive C-reactive protein (hsCRP) levels decrease after primary aldosteronism treatment, indicating reduced cardiovascular risk. However, these biomarkers do not independently predict treatment cure.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Biomarker Research
Background:
- Copeptin and high-sensitive C-reactive protein (hsCRP) are established mortality risk markers in cardiovascular and general populations.
- No prior data existed on these biomarkers in patients with primary aldosteronism.
Purpose of the Study:
- To investigate copeptin and hsCRP as potential cardiovascular risk markers in primary aldosteronism.
- To assess changes in these biomarkers following treatment for primary aldosteronism.
Main Methods:
- A cohort of 113 primary aldosteronism patients was matched with 339 controls from a population-based survey.
- Copeptin and hsCRP levels were measured at baseline and after treatment initiation.
- Statistical analysis compared biomarker levels between patients and controls, and assessed changes post-treatment.
Main Results:
- Primary aldosteronism patients exhibited higher baseline hsCRP compared to controls.
- Specific therapy led to significant reductions in both hsCRP and copeptin levels.
- While sex, hypokalemia, lateralization index, and blood pressure predicted outcomes, copeptin and hsCRP did not independently predict cure.
Conclusions:
- Decreasing copeptin and hsCRP levels post-treatment suggest successful cardiovascular risk reduction in primary aldosteronism.
- These biomarkers are not independent predictors of achieving a cure for primary aldosteronism.
Context:
Copeptin and high-sensitive C-reactive protein (hsCRP) are biomarkers associated with increased mortality in patients with cardiovascular and cerebrovascular disease as well as in the general population. No data exist regarding these markers in patients with primary aldosteronism.
Objective:
To evaluate copeptin and hsCRP levels as cardiovascular risk markers in primary aldosteronism patients.
Methods:
A total of 113 primary aldosteronism patients (64% male) from two centers of the prospective German Conn's Registry were identified, for whom a full data set and blood samples at baseline and follow-up (14 ± 3.4 months) after initiation of specific primary aldosteronism treatment were available. These cases were matched 1 : 3 (n = 339) for sex, renal function, BMI, age and SBP with participants from the Cooperative Health Research in the Region of Augsburg F4 survey. Copeptin and hsCRP were determined by sandwich fluoroimmunoassay.
Results:
HsCRP was significantly higher in primary aldosteronism patients at baseline compared with matched controls. Following specific therapy, hsCRP and copeptin decreased significantly in primary aldosteronism patients [median (25th and 75th percentile): 1.6 (0.8, 3.4) to 1.2 (0.6, 2.1) mg/l, P < 0.001; 7.8 (4.6, 13.5) to 5.0 (3.1, 8.9) pmol/l, P < 0.001, respectively]. Men had higher hsCRP and copeptin levels at baseline and follow-up compared with women. The combination of sex, hypokalemia, lateralization index and blood pressure were the best predictors of outcome. However, copeptin and hsCRP had no predictive value despite the association of lower copeptin levels with better outcome regarding cure of primary aldosteronism.
Conclusion:
Copeptin and hsCRP levels decrease following specific primary aldosteronism therapy reflecting successful cardiovascular risk reduction. However, they are no independent predictors regarding cure of primary aldosteronism.
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