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Diagnostic accuracy of adding copeptin to cardiac troponin for non-ST-elevation myocardial infarction: A systematic review and meta-analysis

Title
Diagnostic accuracy of adding copeptin to cardiac troponin for non-ST-elevation myocardial infarction: A systematic review and meta-analysis
Author
최규선
Keywords
ACUTE CORONARY SYNDROME; HIGH-SENSITIVITY TROPONIN; EARLY RULE-OUT; ACUTE CHEST-PAIN; EMERGENCY-DEPARTMENT; INCREMENTAL VALUE; RAPID RULE; UNIVERSAL DEFINITION; ASSAYS; BIOMARKERS
Issue Date
2018-07
Publisher
PUBLIC LIBRARY SCIENCE
Citation
PLOS ONE, v. 13, no. 7, Article no. e0200379
Abstract
IntroductionThis 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.Materials and methodsA 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.ResultsThe 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).ConclusionsAdding 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.
URI
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200379https://repository.hanyang.ac.kr/handle/20.500.11754/119412
ISSN
1932-6203
DOI
10.1371/journal.pone.0200379
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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