Clinical Significance Of Serum Copeptin Levels In Patients With Coronary Heatr Disease

Background: Cardiovascular diseases has been ranked as the first reason of humandeath, coronary heart disease (CHD) is the important part of cardiovascular diseases，the early examination is great significance for the prediction of cardiovascular events.As one of the biomarkers of cardiovascular, copeptin has been more and moreattentioned by researchers. The precursor of arginine vasopressin (AVP), thecarboxyl-terminal (C terminal) part of which is copeptin. Copeptin is secreted equalwith arginine vasopressin (AVP) in the blood circulation. Copeptin in the body ismore stable and tested more convenient than arginine vasopressin. A recent study hasbeen found that copeptin can be a marker of acute stress in vivo, it also can be amarker of myocardial infarction and a marker of heart failure. It has a high clinicalvalue that copeptin can be to diagnosis and ruled out coronary heart disease andevaluation of prognosis, especially acute myocardial infarction.Objective: Assay for the measurement of serum copeptin levels in Patients withcoronary heart disease, to discuss the relationships of copeptin and coronary heartdisease, and its clinical significance.Methods: Coronary angiography（CAG）was performed in94hospitalized patientswho were suspected as having coronary disease（CHD） because of chest pain.According to coronary angiography findings, Patients were divided into two groups：CHD group（n=71）and non-CHD group as control（n=23）; the CHD group werefurther divided into3subgroups: stable angina pectoris(SAP,n=20), unstable anginapectoris(UAP,n=19), and acute myocardial infarction(AMI,n=32); according toGensini’s scroe,the CHD group were further divided into3subgroups: mild stenosisgroup (n=18, Gensini’s scroe<30), moderate stenosis group (n=24,30≤Gensini’sscroe<60), and severe stenosis group (n=29,Gensini scroe≥60). According to thepost-AMI patients with HF or not, the AMI group were assigned into the AMI group with HF（n=19）and AMI group without HF（n=13）. Before performing CAG, for allpeople there something including fasting plasma glucose blood test (FPG),triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C), high sensitivity C-reactive protein(hsCRP), creatine kinase (CK-MB), and troponin I (cTnI) were given to measured.The articles including smoking, diabetes mellitus, hypertension, measured body massindex (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and otherrelated indicators were recorded. The blood (5ml) were drawed from all patientsbefore performing CAG, the blood were centrifugationed, then the serum extractedfrom the blood were placed in-80℃refrigerator. Enzyme linked immunosorbentassay(ELISA) were adopted to detect the mass of copeptin from the serum. Theexperimental datas were statistically analyzed by SPSS17.0software.The value of P<0.05was considered statistically significant.Results:(1) Serum copeptin(pmol/L) in CHD patients were significantly higher thanin normal control group (26.64±7.56vs5.67±1.79, P <0.01); serum copeptin in AMIpatients were significantly higher than in UAP group (45.41±13.49vs15.90±4.97, P<0.01); serum copeptin in UAP group were significantly higher than in SAP group(15.90±4.97vs6.81±1.67, P <0.01); there were not significant difference between thecontrol group and SAP group, P>0.05.(2)Serum copeptin was positively correlated tohsCRP. In the CHD group, the correlation coefficient r is0.861, P <0.05; in all casesthe correlation coefficient r is0.823, P <0.05; but they were not correlations in thecontrol group, P>0.05.(3) Serum copeptin in severe stenosis patients were higherthan the control group, mild stenosis group,and moderate stenosis group, P <0.01;copeptin in the moderate stenosis group were higher than the control group, mildstenosis group, P <0.01; there were not significant difference between the controlgroup and the mild stenosis group, P>0.05.(4) Compared with the AMI groupwithout HF, the copeptin in the AMI group with HF were significantlyhigher(57.02±16.32vs28.42±7.60, P<0.01).(5) Serum copeptin was positivelycorrelated to BMI, hypertension, diabetes; it was not correlated with age, sex,smoking history, TG, TC, LDL-C, HDL-C and other traditional risk factors. Conclousion:(1)Serum copeptin may be correlate with the severity of coronary heartdisease.(2)Copeptin levels is closely associated with coronary artery disease, it can beused as an indicator of coronary risk stratifications; the angina patients with high levelof copeptin, should be taked positive measures of medical intervention.(3)Copeptinmay be involved in stress response of patients with coronary heart disease, it is valuedof diagnosis and ruled out acute myocardial infarction.(4) Acute myocardialinfarction patients with sustained high levels of copeptin will be unfavourableprognosis, heart failure will complicated easily.(5)Serum copeptin level waspositively related with hsCRP in coronary artery disease patients. This conclusionsuggested that copeptin may be involved with inflammation; Serum copeptin levelwas positively related with BMI, hypertension and diabetes, and it was not correlatedwith other risk factors (such as age, gender, smoking, TG, TC, LDL-C, HDL-C and soon).