Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction: a systematic review and meta-analysis

Tatiana Raskovalova, Raphael Twerenbold, Paul O. Collinson, Till Keller, Hélène Bouvaist, Christian Folli, Davide Giavarina, Ulrich Lotze, Kai M. Eggers, Anne Marie Dupuy, Camille Chenevier-Gobeaux, Christophe Meune, Alan Maisel, Christian Mueller, José Labarère

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

AIMS: This systematic review aimed to investigate the diagnostic accuracy of combined cardiac troponin (cTn) and copeptin assessment in comparison to cTn alone for early rule-out of acute myocardial infarction (AMI).

METHODS: Primary studies were eligible if they evaluated diagnostic accuracy for cTn with and without copeptin in patients with symptoms suggestive of AMI. AMI was defined according to the universal definition, using detection of cTn as a marker for myocardial necrosis. Eligible studies were identified by searching electronic databases (Medline, EMBASE, Science Citation Index Expanded, CINAHL, Pascal, and Cochrane) from inception to March 2013, reviewing conference proceedings and contacting field experts and the copeptin manufacturer.

RESULTS: In 15 studies totalling 8740 patients (prevalence of AMI 16%), adding copeptin improved the sensitivity of cTn assays (from 0.87 to 0.96, p=0.003) at the expense of lower specificity (from 0.84 to 0.56, p

CONCLUSION: Despite substantial between-study heterogeneity, this meta-analysis demonstrates that copeptin significantly improves baseline cTn sensitivity. Management studies are needed to establish the effectiveness and safety of measuring copeptin in combination with high-sensitivity cTnT for early rule-out of AMI without serial testing.

Original languageEnglish
Pages (from-to)18-27
Number of pages10
JournalEuropean Heart Journal: Acute Cardiovascular Care
Volume3
Issue number1
DOIs
Publication statusPublished - Mar 1 2014

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Troponin
Meta-Analysis
Myocardial Infarction
copeptins
Necrosis
Databases
Safety

Keywords

  • copeptin
  • diagnostic accuracy
  • myocardial infarction
  • troponin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction : a systematic review and meta-analysis. / Raskovalova, Tatiana; Twerenbold, Raphael; Collinson, Paul O.; Keller, Till; Bouvaist, Hélène; Folli, Christian; Giavarina, Davide; Lotze, Ulrich; Eggers, Kai M.; Dupuy, Anne Marie; Chenevier-Gobeaux, Camille; Meune, Christophe; Maisel, Alan; Mueller, Christian; Labarère, José.

In: European Heart Journal: Acute Cardiovascular Care, Vol. 3, No. 1, 01.03.2014, p. 18-27.

Research output: Contribution to journalArticle

Raskovalova, T, Twerenbold, R, Collinson, PO, Keller, T, Bouvaist, H, Folli, C, Giavarina, D, Lotze, U, Eggers, KM, Dupuy, AM, Chenevier-Gobeaux, C, Meune, C, Maisel, A, Mueller, C & Labarère, J 2014, 'Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction: a systematic review and meta-analysis', European Heart Journal: Acute Cardiovascular Care, vol. 3, no. 1, pp. 18-27. https://doi.org/10.1177/2048872613514015
Raskovalova, Tatiana ; Twerenbold, Raphael ; Collinson, Paul O. ; Keller, Till ; Bouvaist, Hélène ; Folli, Christian ; Giavarina, Davide ; Lotze, Ulrich ; Eggers, Kai M. ; Dupuy, Anne Marie ; Chenevier-Gobeaux, Camille ; Meune, Christophe ; Maisel, Alan ; Mueller, Christian ; Labarère, José. / Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction : a systematic review and meta-analysis. In: European Heart Journal: Acute Cardiovascular Care. 2014 ; Vol. 3, No. 1. pp. 18-27.
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