Patologìâ (Dec 2018)

Prognostic value of serum copeptin level in patients with subarachnoid haemorrhage

  • N. M. Buchakchyiska,
  • K. Yu. Polkovnikova

DOI
https://doi.org/10.14739/2310-1237.2018.3.151867
Journal volume & issue
Vol. 15, no. 3
pp. 372 – 377

Abstract

Read online

Subarachnoid haemorrhage (SAH) is one of the most common forms of intracranial vascular pathology and one of the severest types of cerebral circulation disorders. According to epidemiology, up to 5000 cases of SAH of an aneurysmal genesis occur annually in Ukraine with an average incidence of 12 cases / 100.000 / year per 45 million people. Purpose of the study. Evaluation of diagnostic informativeness of сopeptin serum values in determining the risk of complications in patients with subarachnoid hemorrhage. Materials and methods. A prospective, cohort study of 82 patients (40 men and 42 women, mean age 49.6 ± 1.3 years) was conducted. The diagnosis was made on the basis of clinical neuroimaging criteria. Aneurysmal genesis of SAH according to cerebral angiography was verifid in 58 (71.9 %). Serum copeptin level was determined on the 3rd day of the disease by ELISA. The development of a complex of SAH complications in the form of secondary ischemia and cerebral angiospasm was considered as the primary end point. The threshold value of serum concentration of copeptin in the assessment of the risk of the development of SAH complications was determined by the results of ROC analysis. Results. The combination of SAH complications was diagnosed in 27 (32.9 %) patients, while the serum level of copeptin in this subcohort was signifiantly higher than that in the group of patients without complications by 44.2 % 0.738 (0.667–0.800) ng / ml versus 0.419 (0.347–0.549), P ˂ 0.01). The serum level of copeptin ≥0.605 ng / ml was found to be associated with an increase in the cumulative risk of SAH complications by 9.5 times (95 % CI 3.6–24.8, P ˂ 0.0001; AUC = 0.95 ± 0.02 95 % CI 0.90-0.99, P = 0.001; diagnostic accuracy is 85.4 %; sensitivity – 85.2 %, specifiity – 85.5 %). Conclusion. The serum level of copeptin is a highly informative marker for the detection of individual cumulative risk of complications in patients with SAH.

Keywords