Prognostic Value of Copeptin One-Year Outcome in Patients With Acute Stroke

Background and Purpose—An accurate long-term outcome prediction may improve management of stroke patients. We investigated the ability of copeptin to predict 1-year outcome in stroke patients. Methods—In this preplanned post hoc analysis, the National Institutes of Health Stroke Scale score and copeptin levels were measured on admission in a cohort of patients with ischemic stroke. The primary end point was functional outcome (modified Rankin Scale score 3 or 3–6) after 1 year. The secondary end point was all-cause mortality. Results—Of 362 patients, 341 (94.2%) completed the 1-year follow-up, 146 (43%) patients had an unfavorable functional outcome, and 66 (20%) died. Multivariate logistic-regression analysis adjusted for age and National Institutes of Health Stroke Scale score showed that copeptin was an independent predictor of functional outcome (odds ratio4.00; 95 % CI, 1.94–8.19) and death (odds ratio2.68; 95 % CI, 1.24–5.82). The area under the receiver operating characteristic curve of copeptin was 0.72 (95 % CI, 0.67–0.77) for functional outcome and 0.74 (95 % CI, 0.69–0.78) for mortality. Copeptin improved the area under the receiver operating characteristic curve of the National Institutes of Health Stroke Scale score for functional outcome from 0.70 (95 % CI, 0.64–0.74) to 0.76 (95 % CI, 0.71–0.82; P0.002) and for mortality from 0.74 (95 % CI, 0.69–0.78) to 0.78 (95 % CI, 0.71–0.85; P0.04). Conclusions—Copeptin levels are a useful, complementary tool to predict functional outcome and mortality 1 year after stroke