Copeptin associates with major adverse cardiovascular events in patients on maintenance hemodialysis
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Published on: October 2, 2020
Zhen Zhang1, Lin Zhang1, Xinyue Dong2
1Department of Nephrology, Zhongshan Hospital, Fudan University, No 180 Fenglin Road, Shanghai, China; Shanghai Key Laboratory of Kidney and Blood Purification, University, No 180 Fenglin Road, Shanghai, China.
Insights
Elevated copeptin levels predict major adverse cardiovascular events (MACEs) in hemodialysis patients. Combining copeptin with other biomarkers improves cardiovascular risk stratification for better patient management.
Area of Science:
- Nephrology
- Cardiology
- Biomarker Research
Background:
- End-stage renal disease (ESRD) patients on hemodialysis face high cardiovascular risks.
- Cardiovascular disease (CVD) is a primary cause of mortality in this population.
- Copeptin shows potential as a biomarker for cardiovascular stress in chronic kidney disease (CKD).
Purpose of the Study:
- To evaluate the prognostic value of copeptin in predicting major adverse cardiovascular events (MACEs).
- To compare copeptin's predictive ability against traditional cardiac biomarkers.
- To assess the utility of copeptin in hemodialysis patients.
Main Methods:
- 351 ESRD patients on maintenance hemodialysis were enrolled.
- Copeptin levels were measured, and patients were monitored for MACEs (cardiovascular death, myocardial infarction, stroke, heart failure hospitalization).
- Cox proportional-hazards models were used for outcome analysis, adjusting for covariates.
Main Results:
- Elevated copeptin significantly correlated with increased MACE risk (HR 1.519, p=0.00425).
- Copeptin demonstrated predictive capability across various statistical tests.
- Integrating copeptin with NT-proBNP or hs-cTnT enhanced MACE risk stratification.
Conclusions:
- Elevated copeptin is an independent predictor of adverse cardiovascular outcomes in hemodialysis patients.
- Incorporating copeptin into risk assessments may improve personalized treatment strategies.
- Copeptin aids in refining risk stratification for high-risk hemodialysis populations.
Background:
End-stage renal disease (ESRD) necessitating hemodialysis pose substantial cardiovascular risks, with cardiovascular disease (CVD) as a leading cause of mortality. Biomarkers like copeptin have emerged as potential indicators of cardiovascular stress and prognosis in CKD populations.
Objective:
This study aimed to assess the prognostic value of copeptin in predicting major adverse cardiovascular events (MACEs) among hemodialysis patients, alongside traditional cardiac biomarkers.
Methods:
ESRD patients undergoing maintenance hemodialysis were enrolled. Copeptin levels were measured, and patients were followed for MACEs, defined as cardiovascular deaths, myocardial infarction, stroke, or heart failure-related hospitalizations. Cox proportional-hazards models were used to evaluate the association between copeptin and outcomes, adjusting for relevant covariates.
Results:
Among 351 patients followed for a median of 22.7 months, elevated copeptin levels were significantly associated with an increased risk of MACEs (HR 1.519, 95 % CI 1.140 to 2.023; p = 0.00425). Copeptin demonstrated predictive capability across multiple statistical tests (Log-rank p = 0.024; Gehan p < 0.001; Tarone-Ware p < 0.001; Peto-Peto p = 0.027), although significance was attenuated in pairwise comparisons post-adjustment for multiple testing. Combining copeptin with NT-proBNP or hs-cTnT further enhanced risk stratification for MACEs.
Conclusion:
Elevated copeptin levels independently predict adverse cardiovascular outcomes in hemodialysis patients. Integrating copeptin with traditional cardiac biomarkers may refine risk stratification and guide personalized therapeutic strategies in this high-risk population.
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