Clinical Significance In The Detection Of Circulatiog Blood Copeptin In Patients With Chronic Heart Failure

206cases of chronic heart failure (CHF) patients in the hospital wereselected in this study. Another67healthy persons were selected as controlgroup. The occurrence of cardiac events (Cardiac death) of the patientswith chronic heart failure during their hospitalization, after they weredischarged for one month, three months, six months and twelve months.The concentration of copeptin in patients with chronic heart failure weredetermined by enzyme linked immunosorbent assay(ELISA) and thencombined its and N end of the B-type natriuretic peptide precursor(NT-proBNP) to explore the value of the assessment of the diagnosis, riskstratification, prognosis in patients with chronic heart failure.According to NYHA classification,206cases of chronic heart failurepatients were divided into cardiac function III+IV group and cardiacfunction I+II group. Analyze the differences of the concentration ofcopeptin and NT-proBNP amsisong CHF group, control group, differentcardiac function groups; The results show: the concentrations ofNT-proBNP and copeptin in patients with chronic heart failure weresignificantly higher than that of control group, and the concentrations ofNT-proBNP and copeptin in the cardiac function III+IV group weresignificantly higher than that in cardiac function I+II group; Thedifference was statistically significant (P<0.05). By using of the pearsoncorrelation analysis, analyze the correlation among the patients withchronic heart failure copeptin, NT-proBNP, UA, CREA, TG, LDL-C andLVEF. The analysis showed that the concentration of copeptin havepositive correlation with NT-proBNP, UA concentration, the correlationcoefficients were0.562,0.342(P<0.01), and have negative correlation with LVEF, the correlation coefficient was-0.322(P=0.012). It meansthat there is certain clinical value of copeptin and NT-proBNPconcentration on the diagnosis and disease evaluation and riskstratification in patients with chronic heart failure.According to the occurrence of cardiac events(Cardiac death)during thefollow-up period, the patients with chronic heart failure were divided intodeath group and survival group, and the predictive factors of short-termprognosis of them were analyzed. The analysis showed that serumcopeptin, NT-proBNP, UA concentration and age in the death group wassignificantly higher than the survival group, and the difference wasstatistically significant (P<0.05), LVEF in the death group wassignificantly lower than the survival group, the difference was statisticallysignificant (P<0.05). It showed that copeptin, NT-proBNP, UA, age andLVEF had correlation with the short-term poor prognosis in patients withchronic heart failure. In addition, the analysis different levels of copeptinin patients with chronic heart failure of the Kaplan Meier survival curve,displayed the mortality of patients increased significantly with increasing.The cardiac events (Cardiac death) as the dependent variable,Hyperuricemia and Gender as a categorical variable, systolic bloodpressure(SBP), Age, left ventricular ejection fraction (LVEF),NT-proBNP and copeptin as a continuous variable, wrer put to two yuanlogistic regression analysis. The results showed that: under the0.05levelin the test, the variables Age, LVEF, NT-proBNP and copeptin havestatistical significance, and Hyperuricemia close to the level of a test, butthe variables of SBP and gender had no statistical significance. Therefore,the variables Age, LVEF, NT-proBNP and copeptin had better predictivevalue for cardiac events. The variables Hyperuricemia, gender and SBPhave little significance for predicting cardiac events. The age, LVEF,NT-proBNP and copeptin can be used as an independent predictor ofshort-term prognosis of patients with chronic heart failure. According to the number of deaths in patients with chronic heartfailure, during their hospitalization and12months after discharge, drawthe prognosis determination ROC curve of copeptin and NT-proBNP forchronic heart failure. The area under the ROC curve was0.871and0.828(P=0.000. It showed that compared with the0.5, two areas hadstatistical significance.). The blood copeptin and NT-proBNPconcentrations were consistent with condition of the prediction of cardiacdeath, because both were in the area of between0.7~0.9, and its forecastability was medium. The95%confidence interval of both copeptin andNT-proBNP were respectively (0.749,0.906) and (0.807,0.935), becausethere was overlap for two confidence intervals. So there was no statisticaldifference between the area under the two curves. This indicates thatcopeptin and NT-proBNP on the short-term prognosis of patients withchronic heart failure judgment have the same important clinical value.Draw the survival curve of different copeptin and NT-ProBNP levels inpatients with chronic heart failure with combination of copeptin andNT-ProBNP. The results showed that: copeptin and NT-ProBNP level ishigher, the mortality is also higher. It shows that the combined detectionof copeptin and NT-ProBNP can improve the value of the prognosis ofchronic heart failure.