Prognostic Value of Hypothalamic Copeptin in Acute Ischemic Stroke

Background: Some studies showed that copeptin, a hypothalamic hormone derived from the precursor of vasopressin, may be useful in the prediction of outcome of ischemic cerebral stroke. The aim of this work was to search if there is any correlation between serum copeptin, in the first day of ischemic stroke, and its clinical severity, radiological findings and also its predictive value of functional outcome in these patients. Methods: This study was conducted on 55 patients of both sexes with ischemic cerebral stroke admitted to Neurology Department, Menofyia University within 24 hours of the onset of ischemic stroke. Patients were subjected to general and neurological examination, laboratory assessment (routine and serum level of copeptin), and brain computerized tomography (CT), or magnetic resonance imaging (MRI). The anatomical site of stroke was evaluated by using the Oxford Community Stroke Project (OCSP) classification. The etiological subtypes of stroke were classified according to Trial of Organization 10172 in Acute Stroke Treatment (TOAST) classification. Stroke severity was evaluated by Scandinavian stroke scale (NIHSS) and disability by modified Rankin scale (MRS) at admission and at 30 days. Results: The results showed high statistically significant correlation between the mean value of copeptin level and severity of stroke on admission (P < 0.001), and also with the size of the infarction (P < 0.001). There was statistically significant difference (P = 0.011) of copeptin level among the studied groups regarding the site of stroke. Additionally, there was high statistically significant difference (P < 0.001) between copeptin level and the etiological subtypes of stroke. The favorable outcome of the stroke was with cutoff point of copeptin below 21.5 ng/mL. Conclusion: Serum copeptin may help in the prediction of severity of ischemic stroke, its size, site, etiological subtypes and functional outcome. J Neurol Res. 2016;6(2-3):41-45 doi: http://dx.doi.org/10.14740/jnr377w