Biomarkers · Cardiac & Hemodynamics
Copeptin
Lower values go with lower risk of death. No risk curve catalogued yet.
Published risk of death1.70×admission copeptin level (continuous; contrast not reported), age-adjusted (95% CI 1.20–2.50) · Post hoc analysis of 359 PARTI trial patients visiting their GP for a respiratory infection (Switzerland), 10-year follow-up, mortality 9.8%
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in Copeptin, study by study
7 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| pharmacologic | Subcutaneous dulaglutide 1.5 mg once weekly for 3 weeks vs placebo in crossover trials of patients with primary polydipsia and healthy participants | Copeptin fell 12% vs placebo after 3 weeks (median within-subject difference -.7 pmol/L); n=54 | RCT | Leibnitz S, et al. Eur J Endocrinol. 2026;194(2):91-101. |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| exercise | A single 60-minute bout of exercise at 75% VO2max in healthy young men fasting/not drinking for 6 h beforehand | Copeptin rises about 2.5-fold, from 4.5 to 10.6 pmol/L, immediately after 1 h of exercise and falls to 7.7 pmol/L one hour later | RCT | Popovic M, Timper K, Seelig E, et al. Exercise upregulates copeptin levels… |
| pharmacologic | Dapagliflozin 10 mg once daily for 4 weeks in NYHA I/II heart failure with reduced ejection fraction (DAPA-Shuttle1) | Serum copeptin rises by 7.8 pmol/L (95% CI 2.77-12.81) after 4 weeks (5.5 pmol/L within 48 h), reflecting compensatory vasopressin-driven water conservation | RCT | Marton A, Saffari SE, Rauh M, et al. Water Conservation Overrides Osmotic… |
| pharmacologic | Tolvaptan split-dose therapy in adults 18-50 with autosomal dominant polycystic kidney disease (TEMPO 3:4) | Copeptin rises from 6.3 to 21.9 pmol/L by week 3 of tolvaptan; larger rises predicted better kidney outcomes | RCT | Gansevoort RT, van Gastel MDA, Chapman AB, et al. Plasma copeptin levels… |
| pharmacologic | Oral sotagliflozin 400 mg daily vs placebo as an adjunct to insulin for 24 weeks in adults with type 1 diabetes (inTandem3 biomarker substudy) | Copeptin rose 33% with sotagliflozin vs placebo at 24 weeks; n=362 | RCT | Nardone M, et al. Diabetes Obes Metab. 2026;28(4):3254-3263. |
| pharmacologic | Dapagliflozin for 6 weeks vs placebo in a crossover trial of patients with chronic kidney disease without diabetes (DIAMOND) | Copeptin rose 7.3 pmol/L (95% CI 0.1 to 14.5) vs placebo at 6 weeks; n=53 | RCT | Sen T, et al. Diabetes Obes Metab. 2022;24(8):1578-1587. |
| pharmacologic | Tolvaptan for 3 days vs fluid restriction in hospitalised patients with hyponatraemia (TVFR trial) | Copeptin rose 8.4 pmol/L (95% CI 2.1 to 14.6) vs fluid restriction over 3 days; n=45 | RCT | Warren AM, et al. Clin Endocrinol (Oxf). 2026;105(4):514-518. |
What else moves this marker
They describe those study groups, not an individual, and an association is not a cause.
Diseases and conditions
| What | Effect on the marker | Comparison · population | Source |
|---|---|---|---|
| ↑ Decompensated cirrhosis, 90-day non-survivors · ratio of mean copeptin in patients who died within 90 days vs those who survived | ratio 2.33 (95% CI 2.17 to 2.5) | 90-day non-survivors vs survivors, decompensated cirrhosis · Hospitalised patients with decompensated cirrhosis (median MELD 18), 103 studies | meta analysis · PMID 37884354 |
| ↑ Preeclampsia (3rd trimester) · preeclamptic vs healthy pregnant women, third trimester | SMD +1.74 (95% CI 0.96 to 2.53) | preeclampsia vs healthy pregnancy, 3rd trimester · Pregnant women, 16 observational studies | meta analysis · PMID 32388342 |
| ↑ Sepsis · sepsis patients vs controls | SMD +1.49 (95% CI 0.81 to 2.16) | sepsis vs controls · Sepsis patients vs controls, 15 studies | meta analysis · PMID 38668663 |
| ↑ Type 2 myocardial infarction / acute myocardial injury (vs type 1 MI) · median plasma copeptin 21.4 pmol/L in T2MI/injury vs 8.1 pmol/L in T1MI | +13.3 pmol/L | T2MI or acute myocardial injury vs T1MI, non-ST-elevation patients with raised cTnI · Emergency department patients with elevated cTnI (78 T1MI, 76 T2MI/injury); external validation n=1390 | cross sectional · PMID 38369132 |
Sources
Related markers: Abdominal Aortic Calcification (AAC) · Ankle-Brachial Index (ABI) · Cardiac (Valvular/Annular) Calcification · Carotid Intima-Media Thickness (CIMT) · Carotid-Femoral Pulse Wave Velocity (PWV) · Coronary Artery Calcium Score (Agatston) · Corrected QT Interval (QTc) · Diastolic Blood Pressure (DBP)