Copeptin is the C-terminal peptide cleaved from provasopressin in the release of vasopressin. It is a marker of vasopressin release during acute stress and is easier to measure than vasopressin.


Chemistry: glycoprotein with 39 amino acids. The molecular weight is around 2,000 Daltons.


Units: pmol/L

Upper limit of normal reference range: 4.4 pmol/L


Elevated copeptin concentrations are associated with a worse outcome for patients with:

(1) ischemic stroke

(2) sepsis

(3) acute myocardial infarction

(4) acute exacerbation of COPD

(5) community-acquired pneumonia


The cutoff for poor outcome depends on the outcome, the assay and the condition.


Factors affecting serum levels:

(1) corticosteroid therapy: inhibits release, with lower serum concentrations

(2) renal insufficiency: associated with elevated serum levels

(3) malignancy: associated with elevated serum levels


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