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Stroke Research and Treatment
Volume 2015 (2015), Article ID 768401, 4 pages
Clinical Study

Copeptin: Limited Usefulness in Early Stroke Differentiation?

1Division of Emergency Medicine, Department of Cardiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany
2B.R.A.H.M.S GmbH, Thermo Scientific Clinical Diagnostics, 16761 Hennigsdorf, Germany
3Department of Neurology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
4Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
5German Center for Neurodegenerative Diseases (DZNE), Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
6German Centre for Cardiovascular Research (DZHK), Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany

Received 18 March 2015; Revised 27 May 2015; Accepted 28 May 2015

Academic Editor: Scott Kasner

Copyright © 2015 Johannes von Recum et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Stroke can be a challenging diagnosis in an emergency-setting. We sought to determine whether copeptin may be a useful biomarker to differentiate between ischemic stroke (IS), transient ischemic attack (TIA), and stroke-mimics. Methods. In patients with suspected stroke arriving within 4.5 hours of symptom-onset, copeptin-levels were measured in initial blood-samples. The final diagnosis was adjudicated by vascular neurologists blinded to copeptin-values. Results. Of all 36 patients with available copeptin-values (median age 71 years, IQR: 54–76; 44% female), 20 patients (56%) were diagnosed with IS, no patient was diagnosed with hemorrhagic stroke, nine patients (25%) were diagnosed with TIA, and seven patients (19%) were stroke-mimics. Copeptin-levels (in pmol/L) tended to be higher in patients with IS [19.1 (11.2–48.5)] compared to TIA [9.4 (5.4–13.8)]. In stroke-mimics the range of values was extremely broad [33.3 (7.57–255.7)]. The diagnostic accuracy of copeptin for IS was 63% with a sensitivity of 80% and a positive predictive value of 64%. Conclusion. In this cohort of patients copeptin-levels within 4.5 hours of symptom onset were higher in patients with IS compared to TIA but the broad range of values in stroke-mimics limits diagnostic accuracy. This trial is registered with UTN: U1111-1119-7602.