Copeptin: Limited Usefulness in Early Stroke Differentiation?
Background. Stroke can be a challenging diagnosis in an emergency-setting. We sought to determine whether copeptin may be a useful biomarker to differentiate between ischemic stroke (IS), transient ischemic attack (TIA), and stroke-mimics. Methods. In patients with suspected stroke arriving within 4...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2015/768401 |
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| author | Johannes von Recum Julia Searle Anna Slagman Jörn Ole Vollert Matthias Endres Martin Möckel Martin Ebinger |
| author_facet | Johannes von Recum Julia Searle Anna Slagman Jörn Ole Vollert Matthias Endres Martin Möckel Martin Ebinger |
| author_sort | Johannes von Recum |
| collection | DOAJ |
| description | Background. Stroke can be a challenging diagnosis in an emergency-setting. We sought to determine whether copeptin may be a useful biomarker to differentiate between ischemic stroke (IS), transient ischemic attack (TIA), and stroke-mimics. Methods. In patients with suspected stroke arriving within 4.5 hours of symptom-onset, copeptin-levels were measured in initial blood-samples. The final diagnosis was adjudicated by vascular neurologists blinded to copeptin-values. Results. Of all 36 patients with available copeptin-values (median age 71 years, IQR: 54–76; 44% female), 20 patients (56%) were diagnosed with IS, no patient was diagnosed with hemorrhagic stroke, nine patients (25%) were diagnosed with TIA, and seven patients (19%) were stroke-mimics. Copeptin-levels (in pmol/L) tended to be higher in patients with IS [19.1 (11.2–48.5)] compared to TIA [9.4 (5.4–13.8)]. In stroke-mimics the range of values was extremely broad [33.3 (7.57–255.7)]. The diagnostic accuracy of copeptin for IS was 63% with a sensitivity of 80% and a positive predictive value of 64%. Conclusion. In this cohort of patients copeptin-levels within 4.5 hours of symptom onset were higher in patients with IS compared to TIA but the broad range of values in stroke-mimics limits diagnostic accuracy. This trial is registered with UTN: U1111-1119-7602. |
| format | Article |
| id | doaj-art-699d1ceecd994b66baaf2a32c367d095 |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-699d1ceecd994b66baaf2a32c367d0952025-08-20T03:33:32ZengWileyStroke Research and Treatment2090-81052042-00562015-01-01201510.1155/2015/768401768401Copeptin: Limited Usefulness in Early Stroke Differentiation?Johannes von Recum0Julia Searle1Anna Slagman2Jörn Ole Vollert3Matthias Endres4Martin Möckel5Martin Ebinger6Division of Emergency Medicine, Department of Cardiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, GermanyDivision of Emergency Medicine, Department of Cardiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, GermanyDivision of Emergency Medicine, Department of Cardiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, GermanyB.R.A.H.M.S GmbH, Thermo Scientific Clinical Diagnostics, 16761 Hennigsdorf, GermanyDepartment of Neurology, Charité-Universitätsmedizin Berlin, 10117 Berlin, GermanyDivision of Emergency Medicine, Department of Cardiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, GermanyDepartment of Neurology, Charité-Universitätsmedizin Berlin, 10117 Berlin, GermanyBackground. Stroke can be a challenging diagnosis in an emergency-setting. We sought to determine whether copeptin may be a useful biomarker to differentiate between ischemic stroke (IS), transient ischemic attack (TIA), and stroke-mimics. Methods. In patients with suspected stroke arriving within 4.5 hours of symptom-onset, copeptin-levels were measured in initial blood-samples. The final diagnosis was adjudicated by vascular neurologists blinded to copeptin-values. Results. Of all 36 patients with available copeptin-values (median age 71 years, IQR: 54–76; 44% female), 20 patients (56%) were diagnosed with IS, no patient was diagnosed with hemorrhagic stroke, nine patients (25%) were diagnosed with TIA, and seven patients (19%) were stroke-mimics. Copeptin-levels (in pmol/L) tended to be higher in patients with IS [19.1 (11.2–48.5)] compared to TIA [9.4 (5.4–13.8)]. In stroke-mimics the range of values was extremely broad [33.3 (7.57–255.7)]. The diagnostic accuracy of copeptin for IS was 63% with a sensitivity of 80% and a positive predictive value of 64%. Conclusion. In this cohort of patients copeptin-levels within 4.5 hours of symptom onset were higher in patients with IS compared to TIA but the broad range of values in stroke-mimics limits diagnostic accuracy. This trial is registered with UTN: U1111-1119-7602.http://dx.doi.org/10.1155/2015/768401 |
| spellingShingle | Johannes von Recum Julia Searle Anna Slagman Jörn Ole Vollert Matthias Endres Martin Möckel Martin Ebinger Copeptin: Limited Usefulness in Early Stroke Differentiation? Stroke Research and Treatment |
| title | Copeptin: Limited Usefulness in Early Stroke Differentiation? |
| title_full | Copeptin: Limited Usefulness in Early Stroke Differentiation? |
| title_fullStr | Copeptin: Limited Usefulness in Early Stroke Differentiation? |
| title_full_unstemmed | Copeptin: Limited Usefulness in Early Stroke Differentiation? |
| title_short | Copeptin: Limited Usefulness in Early Stroke Differentiation? |
| title_sort | copeptin limited usefulness in early stroke differentiation |
| url | http://dx.doi.org/10.1155/2015/768401 |
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