| Objective:Copeptin,the C-terminal fragment of arginine vasopressin,is a new biomarker of heart failure,which is closely related to the occurrence and development of heart failure.At present,there are many basic researches about Copeptin and HF,but there are few systematic evaluations and summaries of the research on the prognosis of Copeptin and HF patients.Therefore,the purpose of this study is to assess the correlation between Copeptin levels and the prognostic value of HF patients.Methods:In Pubmed database,Embase database,cochranelibrary,China knowledge Network,Wanfang and other authoritative databases,we comprehensively searched the Chinese and English literatures on the relationship between serum Copeptin levels and the prognosis of patients with heart failure,and extracted the risk ratio and its 95%confidence interval related to prognosis according to the inclusion and exclusion criteria.The prognostic-related results include death or adverse prognosis events.Adverse prognosis events include rehospitalization and pacemaker implantation.The quality of the selected literature was evaluated,Meta analysis was carried out by Rvman5.3software,and sensitivity analysis and publication bias analysis were carried out to evaluate the stability and reliability of the results.Results:The meta-analysis included 5227 participants in 16 studies.(1)Among the 9 studies of univariate analysis and 7 studies of multivariate analysis on the relationship between Copeptin level and the incidence of Adverse prognosis in patients with heart failure,the heterogeneity was significant in the univariate analysis group(I~2=87%),and there was no heterogeneity in the multifactor analysis group(I~2=0%).After using random effect model and fixed effect model respectively,The combined HR(95%CI)are 1.57(1.26-1.94)and1.67(1.45-1.92)respectively.(2)There were 6 studies of univariate analysis and 8 studies of multivariate analysis of Copeptin level and all-cause mortality in patients with heart failure.There was no heterogeneity among the literatures(I~2=12%,I~2=0%).Fixed effect model with HR(95%CI)was used,which are 2.15(1.88-2.46)and 1.65(1.48-1.85),respectively.(3)There was significant heterogeneity in univariate analysis between opeptin level and the incidence of Adverse prognosis in patients with heart failure(I~2=87%).Subgroup analysis showed that region was the main source of heterogeneity(P<0.1).Gender,type of heart failure,NYHA grade and follow-up time were not the main sources of heterogeneity.(4)Sensitivity analysis:univariate/multivariate analysis of the relationship between Copeptin level and the incidence of Adverse prognosis in patients with heart failure,and univariate/multivariate analysis of Copeptin level and all-cause mortality in patients with heart failure.After the largest and smallest sample size in the removal study,the results showed that the conclusion was reliable and stable.(5)Publication offset analysis:after the publication offset study of the four groups of studies,only the Copeptin level and Adverse prognosis of patients with heart failure were analyzed by univariate analysis,the funnel chart was not completely symmetrical,and there was publication offset.Conclusion:This study shows that circulating Copeptin is a new biomarker of heart failure.High Copeptin levels are associated with the incidence and mortality of HF patients’prognosis,and are risk factors for the prognosis of HF patients.After that,we can further study the best cut-off value of the effect of Copeptin level on the prognosis of patients with heart failure. |
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