Copeptine in cardiocerebrovascular disease

Copeptin (CP) is a 39 amino acid glycopeptide including the C-terminal domain of the arginine-vasopressine precursor. CP is known to be a stable and sensitive surrogate marker for arginine-vasopressine release and it has been investigated as possible diagnostic and prognostic marker in cardiovascular and cerebrovascular diseases. In particular, the role of CP in the early diagnosis of acute myocardial infarction has been widely investigated and various systematic reviews are currently available. CP associated with cardiac troponin T has been reported to carry a good diagnostic accuracy. These data need, however, to be revised according to the introduction of highly sensitive assays for measuring troponins. Although some evidence on the prognostic value of CP in various cardiovascular frameworks is available, natriuretic peptides maintain a leading role. The research on CP is currently investigating its prognostic value in stroke and transient ischemic attack. However, due to the small sample size of studies and the lack of sound evidence, there are no minimal indications for requesting CP in this framework.