Roles of serum copeptin in clinical diagnosis and prognosis evaluation of acute myocardial infarction

doi:10.3969/j.issn.1673-8640.2025.09.004

Abstract

Abstract:

Objective To investigate the role of serum copeptin in the early diagnosis and prognosis assessment of acute myocardial infarction （AMI）. Methods A total of 102 AMI patients（AMI group）and 55 non-AMI patients（control group）from the First Affiliated Hospital of Hunan University of Chinese Medicine from January 2023 to January 2024 were enrolled. The clinical data were collected，and serum copeptin，creatine kinase MB isoenzyme（CK-MB），cardiac troponin（cTn）I，myoglobin（MYO） and blood lipid levels were determined. Receiver operating characteristic（ROC）curve was used to evaluate the efficacy of each index in diagnosing AMI and predicting major adverse cardiovascular events（MACE）within 6 months. Spearman correlation analysis was used to assess the correlation between serum copeptin and CK-MB，cTnI and MYO in AMI patients. Cox proportional hazard regression analysis was used to evaluate the relationship between each indicator and the occurrence of MACE in AMI patients. Results The levels of serum copeptin，CK-MB，MYO and cTnI in AMI group were higher than those in control group（P<0.001）. Serum copeptin was positively correlated with cTnI and MYO levels（r values were 0.578 and 0.624，respectively，P<0.001），but not with CK-MB（r=0.158，p=0.113）. The area under curve（AUC）of serum copeptin for diagnosing AMI was 0.896，and that for predicting MACE within 6 months in AMI patients was 0.810. The AUC of copeptin+cTnI，CK-MB+MYO+cTnI and the combined determination of the 4 indicators for diagnosing AMI were 0.960，0.975 and 0.986，respectively，and those for predicting MACE within 6 months in AMI patients were 0.961，0.958 and 0.949，respectively. Serum copeptin，MYO and cTnI were risk factors for MACE within 6 months in AMI patients [hazard ratios（HR）were 1.005，1.004 and 1.070，95% confidence intervals（CI）were 1.001-1.008，1.000-1.008 and 1.015-1.128，respectively]. Conclusions Serum copeptin has high efficacy in the diagnosis of AMI and the prediction of MACE within 6 months，and it may be used as a biomarker for the early diagnosis and prognosis assessment of AMI.

Key words: Copeptin, Cardiac troponin I, Acute myocardial infarction, Major adverse cardiovascular event

CLC Number:

R446.1

XU Yingqian, WANG Jinquan, PENG Huanzi, PENG Jiaqi, HE Kun, XIE Xiaobing. Roles of serum copeptin in clinical diagnosis and prognosis evaluation of acute myocardial infarction[J]. Laboratory Medicine, 2025, 40(9): 848-855.

Figures/Tables 8

References 32

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组别	例数	性别		年龄/岁	吸烟史/[例（%）]	饮酒史/[例（%）]	糖尿病史/[例（%）]	呼吸系统疾病史/[例（%）]	BMI/（kg·m^-2）
组别	例数	男/例	女/例	年龄/岁	吸烟史/[例（%）]	饮酒史/[例（%）]	糖尿病史/[例（%）]	呼吸系统疾病史/[例（%）]	BMI/（kg·m^-2）
AMI组	102	62	40	62.24±10.77	30（29.4）	26（25.4）	22（21.6）	15（14.7）	23.01±2.82
对照组	55	36	19	65.22±7.89	13（23.6）	20（36.4）	12（24）	6（10.9）	22.44±2.67
统计值		0.322		-1.808	0.599	2.039	0.001	0.445	1.227
P值		0.564		0.073	0.439	0.153	0.971	0.505	0.222
组别	收缩压/kPa			舒张压/kPa		TG/（mmol·L^-1）	TC/（mmol·L^-1）	LDL-C/（mmo·L^-1）	HDL-C/（mmol·L^-1）
AMI组	16.63±0.70			9.18±1.29		1.55±1.05	5.23±0.43	3.1±0.71	1.29±0.19
对照组	16.44±0.86			9.04±1.32		1.41±0.75	5.24±0.49	2.9±0.84	1.3±0.19
统计值	1.523			0.636		0.883	-0.146	1.506	-0.451
P值	0.130			0.525		0.379	0.884	0.134	0.653

组别	例数	性别		年龄/岁	吸烟史/[例（%）]	饮酒史/[例（%）]	糖尿病史/[例（%）]	呼吸系统疾病史/[例（%）]	BMI/（kg·m^-2）
组别	例数	男/例	女/例	年龄/岁	吸烟史/[例（%）]	饮酒史/[例（%）]	糖尿病史/[例（%）]	呼吸系统疾病史/[例（%）]	BMI/（kg·m^-2）
AMI组	102	62	40	62.24±10.77	30（29.4）	26（25.4）	22（21.6）	15（14.7）	23.01±2.82
对照组	55	36	19	65.22±7.89	13（23.6）	20（36.4）	12（24）	6（10.9）	22.44±2.67
统计值		0.322		-1.808	0.599	2.039	0.001	0.445	1.227
P值		0.564		0.073	0.439	0.153	0.971	0.505	0.222
组别	收缩压/kPa			舒张压/kPa		TG/（mmol·L^-1）	TC/（mmol·L^-1）	LDL-C/（mmo·L^-1）	HDL-C/（mmol·L^-1）
AMI组	16.63±0.70			9.18±1.29		1.55±1.05	5.23±0.43	3.1±0.71	1.29±0.19
对照组	16.44±0.86			9.04±1.32		1.41±0.75	5.24±0.49	2.9±0.84	1.3±0.19
统计值	1.523			0.636		0.883	-0.146	1.506	-0.451
P值	0.130			0.525		0.379	0.884	0.134	0.653

组别	例数	和肽素/（pg·mL^-1）	CK-MB/（U·L^-1）	cTnI/（ng·mL^-1）	MYO/（μg·L^-1）
对照组	55	5.02（3.81，6.75）	5.01（2.38，10.50）	0.23（0.06，0.43）	36.10（22.00，50.20）
AMI组	102	12.47（8.18，25.94）	20.00（10.98，52.50）	2.16（0.78，5.75）	80.75（41.25，143.85）
Z值		-8.170	-7.647	-8.592	-6.656
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	和肽素/（pg·mL^-1）	CK-MB/（U·L^-1）	cTnI/（ng·mL^-1）	MYO/（μg·L^-1）
对照组	55	5.02（3.81，6.75）	5.01（2.38，10.50）	0.23（0.06，0.43）	36.10（22.00，50.20）
AMI组	102	12.47（8.18，25.94）	20.00（10.98，52.50）	2.16（0.78，5.75）	80.75（41.25，143.85）
Z值		-8.170	-7.647	-8.592	-6.656
P值		<0.001	<0.001	<0.001	<0.001

指标	联合检测方程	AUC（95%CI^①）	最佳临界值	敏感性/%	特异性/%	约登指数
和肽素		0.896（0.849~0.943）	8.29 pg·mL^-1	73.0	92.7	0.672
和肽素+ cTnI	Logit（P）=-5.108+0.452×和肽素+3.759×cTnI	0.960（0.935~0.986）	0.698	84.3	98.2	0.825
CK-MB+MYO+cTnI	Logit（P）=-5.961+3.875×cTnI+0.217×CK-MB+0.034×MYO	0.975（0.955~0.994）	0.876	91.2	96.4	0.876
4项指标联合	Logit（P）=-9.079+0.530×和肽素+0.262×CK-MB+3.519×cTnI+0.011×MYO	0.986（0.971~1.000）	0.688	94.1	98.2	0.923