Copeptin In Diagnosing And Prognosis Predicting Of Acute Lung Injury

Backgrounds:Copeptin has been studied as an excellent predictor of outcome in a variety of diseases, its value is even superior to that of B-type natriuretic peptide (BNP) in heart failure, but little is known about its characteristics in acute respiratory distress syndrome (ARDS)/acute lung injury (ALI). We sought to assess the diagnostic and prognostic value of copeptin together with N-terminal pro-BNP (NT-proBNP) in patients with ARDS/ALI and cardiogenic pulmonary edema (CPE).Methods:Measurement of copeptin and NT-proBNP levels in plasma from121consecutive patients with either ARDS/ALI or CPE enrolled in a prospective single center study.Results:In a derivation cohort of87patients with ARDS/ALI and34patients with CPE, a copeptin threshold of>40.11pmol/L provided a specificity of88.2%and a sensitivity of60.9%for the diagnosis of ARDS/ALI, a NT-proBNP cut point of <2813pg/ml had a specificity of79.4%and sensitivity of65.5%for it. Multivariate Cox regression analysis showed that copeptin was the strongest predictor for mortality in patients with ARDS/ALI [hazard ratio (HR)=4.72, P<0.001] and CPE (HR=3.52, P=0.019), the association between increasing copeptin and death was statistically significant in patients with ARDS/ALI (HR=2.64, P=0.035) and CPE (HR=1.62, P=0.029).Conclusion:Copeptin of>40.1lpmol/L had a high specificity for the diagnosis of ARDS/ALI in patients presenting with ARDS/ALI and CPE. Compared to NT-proBNP, copeptin was a stronger prognostic marker for short-term mortality.