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>