ORIGINAL ARTICLE |
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Year : 2020 | Volume
: 6
| Issue : 2 | Page : 77-83 |
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Copeptin: Short term prognostic biomarker in ischemic stroke among Indian - A prospective cohort study
Kevin T John1, Ali Hasan Faiz Karnam1, Ravichandran Kandasamy2, Rajalaxmi Sarangi3, Nayyar Iqbal1, Sunil K Nanda4
1 Department of General Medicine, PIMS, Puducherry, India 2 Department of Statistics, PIMS, Puducherry, India 3 Department of Biochemistry, KIMS, Bhubaneshwar, Odisha, India 4 Department of Biochemistry, PIMS, Puducherry, India
Correspondence Address:
Ali Hasan Faiz Karnam Department of General Medicine, PIMS, Puducherry India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jcrsm.jcrsm_31_20
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Background: Copeptin a precursor of arginine vasopressin is associated with stroke severity and functional outcome among Chinese and Western population. We aimed to evaluate copeptin as a prognostic marker in patients with acute ischemic stroke (IS) by assessing the functional outcome of patients after 90 days of stroke.
Methodology: Sixty out of 88 adult patients were included in the study who presented with symptoms of acute stroke within 72 h of onset. Patients with intracranial hemorrhage and transient ischemic attack were excluded from the study. Spearman correlation method was applied to see correlation between copeptin and National Institutes of Health Stroke Scale (NIHSS) calculated at the time of admission. Logistic regression analysis was done to identify independent risk variables for the functional outcome (modified Rankin Scale) of IS. Receiver operating characteristic curve was calculated to find the sensitivity and specificity of copeptin.
Results: Out of 60 patients, 62% were male and 38% were female. The mean age was 57.7 ± 14.8 years. Copeptin levels were high among patients with severe stroke (14.9 ± 0.8). Copeptin at the time of admission showed a significant positive correlation with stroke severity (r = 0.702, P < 0.001). The multiple logistic regression analysis showed that copeptin level (odds ratio [OR]: 3.05, 95% confidence interval [CI]: 1.00–9.32, P = 0.05) and NIHSS at day 0 (OR: 7.05, 95% CI: 1.39–35.78, P = 0.02) were independently associated with functional outcome at day 90. The area under the curve was 0.898, with a sensitivity of 77.8% and specificity of 97.6%, P < 0.001.
Conclusion: Copeptin is independently associated with the severity and functional outcome of IS among Indians. A larger cohort study may be required to further establish its association.
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