Journal
DIABETES CARE
Volume 33, Issue 7, Pages 1604-1606Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc10-0088
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Funding
- Swedish Heart-Lung Foundation
- AFA Insurance
- Family Erling-Persson Foundation
- Signe and Olof Wallenius Foundation
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OBJECTIVE - To determine whether C-terminal provasopressin (copeptin) explains the prognostic importance of insulin growth factor binding protein-1 (IGFBP-1) in patients with myocardial infarction and type 2 diabetes. RESEARCH DESIGN AND METHODS - Copeptin and IGFBP-1 were analyzed in 393 patients participating in the Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) 2 trial. RESULTS - Copeptin was associated with IGFBP-1 (Spearman rank correlation test, r = 0.53; P < 0.001). During follow-up there were 138 cardiovascular events (cardiovascular death, myocardial infarction, and stroke). In univariate Cox proportional hazard regression analyses both biomarkers were predictors of events: the hazard ratio for log copeptin was 1.59 (95% Cl 1.41-1.81; P < 0.001) and for log IGFBP-1 was 1.49 (1.26-1.77; P < 0.001). In the final model, adjusting for age and renal function, copeptin was the only independent predictor (1.35 [1.16 - 1.57]; P < 0.001). CONCLUSIONS - Copeptin is an independent predictor of cardiovascular events and appears to at least partly explain the prognostic impact of IGFBP-1 in patients with type 2 diabetes and myocardial infarction. Copeptin may be a pathogenic factor to address to improve outcome in these patients.
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