Role of copeptin in diagnosis and outcome prediction in patients with heart failure: a systematic review and meta-analysis

Background/Context Heart failure (HF) is a heterogeneous condition characterized by increased morbidity and mortality. Objective This systematic review and meta-analysis of 19 studies was conducted to evaluate the role of copeptin in diagnosis and outcome prediction in HF patients. Materials and methods A systematic literature search for clinical trials reporting copeptin levels in HF patients was performed using EMBASE, PubMed, Cochrane Register of Controlled Trials, and Google Scholar. Articles from databases published by 2 January 2022, that met the selection criteria were retrieved and reviewed. The random effects model was used for analyses. Results Pooled analysis found higher mean copeptin levels in HF vs. non-HF populations (43.6 +/- 46.4 vs. 21.4 +/- 21.4; MD= 20.48; 95% CI: 9.22 to 31.74; p < 0.001). Pooled analysis of copeptin concentrations stratified by ejection fraction showed higher concentrations in HFrEF vs. HFpEF (17.4 +/- 7.1 vs. 10.1 +/- 5.5; MD= -4.69; 95% CI: -7.58 to -1.81; p = 0.001). Copeptin level was higher in patients with mortality/acute HF-related hospitalization vs. stable patients (31.3 +/- 23.7 vs. 20.4 +/- 12.8; MD= -13.06; 95% CI: -25.28 to -0.84; p = 0.04). Higher copeptin concentrations were associated with mortality and observed in all follow-up periods (p < 0.05). Conclusions The present meta-analysis showed that elevated copeptin plasma concentrations observed in HF patients are associated with an increased risk of all-cause mortality, thus copeptin may serve as predictor of outcome in HF.