10.1371/journal.pone.0200379 Hyungoo Shin Hyungoo Shin Bo-Hyoung Jang Bo-Hyoung Jang Tae Ho Lim Tae Ho Lim Juncheol Lee Juncheol Lee Wonhee Kim Wonhee Kim Youngsuk Cho Youngsuk Cho Chiwon Ahn Chiwon Ahn Kyu-Sun Choi Kyu-Sun Choi Diagnostic accuracy of adding copeptin to cardiac troponin for non-ST-elevation myocardial infarction: A systematic review and meta-analysis Public Library of Science 2018 literature search lt MEDLINE copeptin screen NSTEMI emergency department cTn EMBASE Diagnostic accuracy ST elevation ED QUADAS -2 tool study participants search date vs Cochrane Library infarction non-ST elevation meta-analysis Introduction 2018-07-06 17:55:34 Dataset https://plos.figshare.com/articles/dataset/Diagnostic_accuracy_of_adding_copeptin_to_cardiac_troponin_for_non-ST-elevation_myocardial_infarction_A_systematic_review_and_meta-analysis/6771296 <div><p>Introduction</p><p>This study aimed to determine the diagnostic accuracy of adding copeptin to cardiac troponin (cTn) on admission to the emergency department (ED) for non-ST elevation myocardial infarction (NSTEMI) compared to cTn alone.</p><p>Materials and methods</p><p>A literature search of MEDLINE, EMBASE, and the Cochrane Library was performed (search date: April 13, 2018). Primary studies were included if they accurately reported on patients with symptoms suggestive of acute myocardial infarction and measured both cTn alone and cTn with copeptin upon admission to the ED. The patients with evidence of ST elevation myocardial infarction were excluded. To assess the risk of bias for the included studies, the QUADAS-2 tool was used.</p><p>Results</p><p>The study participants included a total of 7,998 patients from 14 observational studies. The addition of copeptin to cTn significantly improved the sensitivity (0.81 [0.74 to 0.87] vs. 0.92 [0.89 to 0.95], respectively, p <0.001) and negative predictive value (0.96 [0.95 to 0.98] vs. 0.98 [0.96 to 0.99], respectively, p <0.001) at the expense of lower specificity (0.88 [0.80 to 0.97] vs. 0.57 [0.49 to 0.65], respectively, p <0.001) compared to cTn alone. Furthermore, adding copeptin to cTn showed significantly lower diagnostic accuracy for NSTEMI compared to cTn alone (0.91[0.90 to 0.92] vs. 0.85 [0.83 to 0.86], respectively, p < 0.001).</p><p>Conclusions</p><p>Adding copeptin to cTn improved the sensitivity and negative predictive value for the diagnosis of NSTEMI compared to cTn alone. Thus, adding copeptin to cTn might help to screen NSTEMI early upon admission to the ED.</p></div>