Stroke: Highlights of Selected Articles

Copeptin is a stress hormone that has previously been shown to be associated with recurrent cerebrovascular events after transient ischemic attack (TIA). The ABCD2 (age, blood pressure, clinical features, duration, diabetes) score and the ABCD3-I (ABCD2 plus dual TIA) score both provide risk assessment for recurrent stroke after TIA. The current study aimed to determine the effect of copeptin in the prediction of recurrent cerebrovascular events (stroke or TIA) within 3 months of TIA. In their cohort, 28 of 302 (9.3%) patients had a recurrent cerebrovascular event within 3 months of TIA. There was no statistically significant difference in copeptin levels in patients with or without recurrent cerebrovascular events. A total of 11 patients had recurrent stroke within 3 months. Copeptin levels were >4× higher in patients with recurrent stroke in comparison with those without stroke. A 10-fold increase in copeptin was associated with an odds ratio of stroke of 3.39 after adjustment for the ABCD2 score. Copeptin increased the prognostic ability of the ABCD2 score in predicting recurrent stroke in 31.2% of patients. In sum, copeptin seems to represent a biomarker with strong prediction value for recurrent stroke after TIA. Further validating studies are needed. But at this time it seems to add in risk stratification of patient presenting with TIA. See p 2918.