Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2025.028

Copeptin as a promising biomarker of cerebrovascular events: A minireview

Kamila Smolikova1, 2, Pavel Potuznik1, 2, Marek Peterka1, 2, Jakub Vejskal1, 2, Martina Pestova3
1 Department of Neurology, University Hospital Pilsen, Pilsen, Czech Republic
2 Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
3 Department of Immunochemical Diagnostics, University Hospital Pilsen, Pilsen, Czech Republic

Cerebrovascular events remain a major health issue, and despite significant improvements in diagnosis and treatment in recent years, their high morbidity and mortality mean that increasing attention is now being given to prevention and early prediction. One option for achieving this is to examine various biomarkers. This mini review covers copeptin, a 39-amino-acid glycopeptide, derived from the precursor protein pre-provasopressin. Copeptin shows great potential in the diagnosis and prognosis of diverse diseases, including cerebrovascular events. Compared to arginine vasopressin or cortisol alone, it shows better potential for use in emergency care due to its rapid determination. Understanding the role of copeptin and its clinical applications is essential for advancing patient care and treatment strategies. This mini review presents selected studies on the use of copeptin as a potential biomarker for cerebrovascular events. Its level correlates with the severity of both clinical and radiological impairment after a stroke. A correlation has been demonstrated between copeptin levels and the ability to predict a cerebrovascular event recurrence within 90 days after a transient ischemic attack. This mini review also includes the limits to copeptin, which are influenced by selected vascular risk factors for cerebrovascular events.

Keywords: copeptin, biomarker, cerebrovascular events, vascular risk factors

Received: May 21, 2025; Revised: September 12, 2025; Accepted: September 22, 2025; Prepublished online: October 15, 2025 

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    References

    1. . Repaske DR, Medlej R, Gültekin EK, Krishnamani MR, Halaby G, Findling JW, Phillips JA. Heterogenity in clinical manifestation of autosomal dominant neurohypophyseal diabetes insipidus caused by a mutation encoding Ala-1-->Val in the signal peptide of the arginine vasopressin/neurophysin II/copeptin precursor. JCEM 1997;82(1):51-6. doi: 10.1210/jcem.82.1.3660 Go to original source... Go to PubMed...
    2. . Nickel CH, Bingisser R, Morgenthaler NG. The role of copeptin as a diagnostic and prognostic biomarker for risk stratification in the emergency department. BMC Med 2012;10:7. doi: 10.1186/1741-7015-10-7 Go to original source... Go to PubMed...
    3. . Thibonnier M, Preston JA, Dulin N, Wilkins PL, Berti-Mattera LN, Mattera R. The human V3 pituitary vasopressin receptor: ligand binding profile and density-dependent signaling pathways. Endocrinology 1997;138(10):4109-22. doi: 10.1210/en.138.10.4109 Go to original source...
    4. . Balík M, Černý V, ©rámek V, Matějovič M, Kunstýř J. Vasopresin a jeho role v anesteziologii a intenzivní medicíně. Anest Intensiv Med 2015;26(4):223-7. (In Czech)
    5. . Rivier C, Vale W. Interaction of corticotropin-releasing factor and arginine vasopressin on adrenocorticotropin secretion in vivo. Endocrinology 1983;113(3):939-42. doi: 10.1210/endo-113-3-939 Go to original source... Go to PubMed...
    6. . Milsom SR, Conaglen JV, Donald RA, Espiner EA, Nicholls MG, Livesey JH. Augmentation of the response to CRF in man: relative contributions of endogenous angiotensin and vasopressin. Clin Endocrinol (Oxford) 1985;22(5):623-9. doi: 10.1111/j.1365-2265.1985.tb02998.x Go to original source... Go to PubMed...
    7. . Katan M, Morgenthaler N, Widmer I, Puder JJ, Konig C, Muller B, Christ-Crain M. Copeptin, a stable peptide derived from the vasopressin precursor, correlates with the individual stress level. Neuro Endocrinol Lett 2008;29(3):341-6.cited 12/2024.PMID:18580851
    8. . Morgenthaler NG, Struck J, Alonso C, Bergmann A. Assay for the measurement of copeptin, a stable peptide derived from the precursor of vasopressin. Clin Chem 2006;52(1):112-9. doi: 10.1373/clinchem.2005.060038 Go to original source... Go to PubMed...
    9. . Abdelmageed M, Güzelgül F. Copeptin: Up-to-date diagnostic and prognostic role highlight. Anal Biochem 2023;673:115181. doi: 10.1016/j.ab.2023.115181 Go to original source... Go to PubMed...
    10. . Katan M, Fluri F, Morgenthaler NG, Schuetz P, Zweifel C, Bingisser R, Muller K, Meckel S, Gass A, Kappos L, Steck AJ, Engelter ST, Muller B, Christ-Crain M. Copeptin: a novel, independent prognostic marker in patients with ischemic stroke. Ann Neurol 2009;66(6):799-808. doi: 10.1002/ana.21783 Go to original source... Go to PubMed...
    11. . Oraby MI, Soliman RH, Abd Elkareem RM, Mohammed AI. Copeptin: a potential blood biomarker for acute ischemic stroke. Egypt J Neurol Psychiatry Neurosurg 2021;57:40. doi: 10.1186/s41983-021-00393-2 Go to original source...
    12. . Zhou Z, Sun F, Jiang J, Dou Z, Lv Y, Zhang Z, Zhou X, Zhao X, Qin Y, Huang B. Establishment and Clinical Application in Stroke of a Serum Copeptin Time-Resolved Fluorescence Immunoassay. J Fluoresc 2024;34:2349-58. doi: 10.1007/s10895-023-03441-7 Go to original source... Go to PubMed...
    13. . Zweifel C, Katan M, Schuetz P, Siegemund M, Morgenthaler NG, Merlo A, Mueller B, Christ-Crain M. Copeptin is associated with mortality and outcome in patients with acute intracerebral hemorrhage. BMC Neurol 2010;10:34. doi: 10.1186/1471-2377-10-34 Go to original source... Go to PubMed...
    14. . Ozkan S, Baykan N, Salt O, Yakar S, Sen A, Durukan P. The role of plasma copeptin level in determining the severity and mortality of subarachnoid hemorrhage. Acta Clinica Croatica 2023;62:595-604. doi: 10.20471/acc.2023.62.04.3 Go to original source... Go to PubMed...
    15. . Katan M, Nigro N, Fluri F, Schuetz P, Morgenthaler NG, Jax F, Meckel S, Gass A, Bingisser R, Steck A, Kappos L, Engelter S, Muller B, Christ-Crain M. Stress hormones predict cerebrovascular re-events after transient ischemic attacks. Neurology 2011;76(6):563-6. doi: 10.1212/WNL.0b013e31820b75e6 Go to original source... Go to PubMed...
    16. . Zeng X, Deng A, Ding Y, Ni Y, Xu T, Liu J, Yang B, Goa M, Ma G, Ding W, Mu L. Copeptin and NT-proBNP as prognostic markers for recurrent ischemic cerebrovascular events in ischemic stroke patients. J Am Coll Cardiol 2016;68(24):2710-11. doi: 10.1016/j.jacc.2016.09.954 Go to original source... Go to PubMed...
    17. . Dong X, Tao DB, Wang YX, Cao H, Xu YS, Wang QY. Plasma copeptin levels in Chinese patients with acute ischemic stroke: a preliminary study. Neurol Sci 2013;34(9):1591-5. doi: 10.1007/s10072-013-1291-2 Go to original source... Go to PubMed...
    18. . Montellano FA, Rücer V, Ungethüm K, Penalba A, Hotter B, Giralt M, Wiedmann S, Mackenrodt D, Morbach C, Frantz S, Störk S, Whiteley WN, Kleinschnitz C, Meisel A, Montaner J, Haeusler KG, Heuschmann PU. Biomarkers to improve functional outcome prediction after ischemic stroke: Results from the SICFAIL, STRAWINSKI, and PREDICT studies. Eur Stroke J 2024;9(4):968-80. doi: 10.1177/23969873241250272 Go to original source... Go to PubMed...
    19. . Furlanis G, G, Ajčević M, Buoite Stella A, Cillotto T, Caruso P, Ridolfi M, Cova MA, Naccarato M, Manganotti P. Wake-up stroke: thrombolysis reduces ischemic lesion volume and neurological deficit. J Neurol 2020;267(3):666-73. doi: 10.1007/s00415-019-09603-7 Go to original source... Go to PubMed...
    20. . Vasile AI, Tiu C, Badiu C. Copeptin as biomarker for acute ischemic stroke prognosis and revascularization treatment efficacy. Front Neurol 2024;15:1447355. doi: 10.3389/fneur.2024.1447355 Go to original source... Go to PubMed...
    21. . Choi KS, Kim HJ, Chun HJ, Kim JM, Yi HJ, Cheong JH, Kim ChH, Oh SJ, Ko Y, Kim YS, Bak KH, Ryu JI, Kim W, Lim T, Ahn HS, Ahn IM, Lee SH. Prognostic role of copeptin after stroke: a systematic review and meta-analysis of observational studies. Sci Rep 2015;5:11665. doi: 10.1038/srep11665 Go to original source... Go to PubMed...
    22. . Vasile AI, Tută S, Tiu C, Badiu C. Copeptin as a new blood-based marker for differential diagnosis in stroke patients. Int J Mol Sci 2025;26(11):5328. doi:10.3390/ijms26115328 Go to original source... Go to PubMed...
    23. . Spagnolello O, De Michele M, Lorenzano S, Cerulli Irelli E, Naitana F, Falcou A, Letteri F, Bachetoni A, Collepardo D, Bertazzoni G, Toni D. Copeptin Kinetics in Acute Ischemic Stroke May Differ According To Revascularization Strategies, Pilot Data. Stroke 2019;50:3632-5. doi: 10.1161/STROKEAHA.119.025433 Go to original source... Go to PubMed...
    24. . Karatzetzou S, Tsiptsios D, Sousanidou A, Fotiadou S, Christidi F, Kokkotis C, Gkantzios A, Stefas E, Vlotinou P, Kaltsatou A, Aggelousis N, Vadikolias K. Copeptin implementation in stroke prognosis. Neurol Int 2023;15(1):83-99. doi: 10.3390/neurolint15010008 Go to original source... Go to PubMed...
    25. . De Marchis GM, Weck A, Audebert H, Benik S, Foerch C, Buhl D, Schuetz P, Jung S, Seiler M, Morgenthaler NG, Mattle HP, Mueller B, Chris-Crain M, Arnold M, Katan M. Copeptin for the prediction of recurrent cerebrovascular events after transient ischemic attack: results from the CoRisk study. Stroke 2014;45(10):2918-23. doi: 10.1161/STROKEAHA.114.005584 Go to original source... Go to PubMed...
    26. . Xu Q, Tian Y, Peng H, Li H. Copeptin as a biomarker for prediction of prognosis of acute ischemic stroke and transient ischemic attack: a meta-analysis. Hypertens Res 2017;40:465-71. doi: 10.1038/hr.2016.165 Go to original source... Go to PubMed...
    27. . Suh SH, Kim SW. A novel role of copeptin as a biomarker for the prediction of treatment response in hyponatremia. Kidney Res Clin Pract 2021;40(3):329-31. doi: 10.23876/j.krcp.21.000 Go to original source... Go to PubMed...
    28. . Morgenthaler NG, Struck J, Jochberger S, Dünser MW. Copeptin: clinical use of a new biomarker. Trends Endocrinol Metab 2008;19(2):43-9. doi: 10.1016/j.tem.2007.11.001 Go to original source... Go to PubMed...
    29. . Blek N, Szwed P, Putowska P, Nowicka A, Drela WL, Gasecka A, Ladny JR, Merza Y, Jaguszewski MJ, Szarpak L. The diagnostic and prognostic value of copeptin in patients with acute ischemic stroke and transient ischemic attack: A systematic review and meta-analysis. Cardiol J 2022;29(4):610-18. doi: 10.5603/CJ.a2022.004 Go to original source...
    30. . Bhandari SS, Loke I, Davies JE, Squire IB, Struck J, Ng LL. Gender and renal function influence plasma levels of copeptin in healthy individuals. Clin Sci (Lond) 2009;116(3):257-63. doi: 10.1042/CS20080140 Go to original source... Go to PubMed...
    31. . Molnár AH, Varga C, Berkó A, Rojik I, Párducz A, László F, László FA. Inhibitory effect of vasopressin receptor antagonist OPC-31260 on experimental brain oedema induced by global cerebral ischaemia. Acta Neurochir (Wien) 2008;150(3):265-71. doi: 10.1007/s00701-007-1400-1 Go to original source... Go to PubMed...
    32. . Wang CB, Zong M, Lu SQ, Tian Z. Plasma copeptin and functional outcome in patients with ischemic stroke and type 2 diabetes. J Diabetes Complications 2016;30(8):1532-6. doi: 10.1016/j.jdiacomp.2016.07.030 Go to original source... Go to PubMed...
    33. . Choy KW, Wijeratne N, Chiang C, Don-Wauchope A. Copeptin as a surrogate marker for arginine vasopressin: analytical insights, current utility, and emerging applications. Crit Rev Clin Lab Sci 2024;62(1):24-44. doi: 10.1080/10408363.2024.2383899 Go to original source... Go to PubMed...

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