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The role of copeptin as a diagnostic and prognostic biomarker for risk stratification in the emergency department

Christian H Nickel1*, Roland Bingisser1 and Nils G Morgenthaler2

Author Affiliations

1 Emergency Department, University Hospital, Basel, Switzerland

2 Institut für Experimentelle Endokrinologie und Endokrinologisches Forschungszentrum, EnForCé, Charité, Campus Virchow, Berlin, Germany

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BMC Medicine 2012, 10:7  doi:10.1186/1741-7015-10-7

Published: 20 January 2012

Abstract

The hypothalamic-pituitary-adrenal axis is activated in response to stress. One of the activated hypothalamic hormones is arginine vasopressin, a hormone involved in hemodynamics and osmoregulation. Copeptin, the C-terminal part of the arginine vasopressin precursor peptide, is a sensitive and stable surrogate marker for arginine vasopressin release. Measurement of copeptin levels has been shown to be useful in a variety of clinical scenarios, particularly as a prognostic marker in patients with acute diseases such as lower respiratory tract infection, heart disease and stroke. The measurement of copeptin levels may provide crucial information for risk stratification in a variety of clinical situations. As such, the emergency department appears to be the ideal setting for its potential use. This review summarizes the recent progress towards determining the prognostic and diagnostic value of copeptin in the emergency department.