Velho G, et al. - In two prospective cohorts of patients with type 2 diabetes, how plasma copeptin is associated with the risk of cardiovascular events was assessed. In addition, researchers assessed if deleterious effects of vasopressin on the kidney mediated any found association. Findings revealed a positive association of plasma copeptin with major cardiovascular events in these cohorts. This association cannot be solely accounted for by the association of copeptin with kidney-related traits.

Methods

• From the French cohorts DIABHYCAR and SURDIAGENE, researchers studied 3,098 and 1,407 type 2 diabetic patients, respectively.
• During follow-up (median: 5 years), they determined the incidence of a combined end point including myocardial infarction, coronary revascularization, hospitalization for congestive heart failure, or cardiovascular death.
• In baseline plasma samples, they measured copeptin concentration by an immunoluminometric assay.

Results

• During follow-up, the cumulative incidence of cardiovascular events by sex-specific tertiles of baseline plasma copeptin in DIABHYCAR was 15.6% (T1), 18.7% (T2) and 21.7% (T3) (p=0.002), and in SURDIAGENE was 27.7% (T1), 34.1% (T2) and 47.6% (T3) (p < 0.0001).
• Cox proportional hazards survival regression analyses established that in both cohorts, copeptin was associated with cardiovascular events: hazard ratio with 95% confidence interval for T3 vs T1 was 1.29 (1.04–1.59), p=0.02 (DIABHYCAR), and 1.58 (1.23–2.04), p=0.0004 (SURDIAGENE), adjusted for sex, age, BMI, duration of diabetes, systolic blood pressure, arterial hypertension, HbA1c, total cholesterol, HDL-cholesterol, triglycerides, estimated glomerular filtration rate (eGFR), urinary albumin concentration (UAC), active tobacco smoking, and previous history of myocardial infarction at baseline.
• Researchers identified no interaction between plasma copeptin and eGFR (p=0.40) or UAC (p=0.61) categories on the risk of cardiovascular events in analyses of pooled cohorts.