Meta-analysis for Clinical Values of Troponin Alone and Troponin Combining Copeptin in Early Diagnosis of Non-ST Segment Elevation Myocardial Infarction / 中国循环杂志

ABSTRACT

Objective: To evaluate the clinical effects of troponin alone and troponin combining copeptin in early diagnosis of Non-ST segment elevation myocardial infarction (NSTEMI) by meta-analysis. Methods: We searched Medline, EMBASE, Cochrane, Pubmed, CNKI and Wanfang database (1995-01 to 2015-10) for the publications of troponin alone and troponin combining copeptin in early diagnosis of NSTEMI. Based on inclusion and exclusion criteria, we screened the literatures and evaluated their quality by QUADAS items. Manager 5.2 and Meta-DiSc 1.4 software were used to study the pooled sensitivity and speciifcity for troponin alone and troponin combining copeptin in NSTEMI early diagnosis, and to calculate the summary receiver operating characteristic curve (SROC) with the area under curve (AUC). Results: There were 11 articles including 1 Chinese article enrolled. For NSTEMI diagnosis, compared with troponin alone, troponin combining copeptin showed the higher sensitivity (90% vs 75%), but lower speciifcity (60% vs 87%). For SROC, both AUC were > 0.7, while the AUC of troponin combining copeptin was even lower (0.805 vs 0.891). Conclusion: Combination of troponin and copeptin had the better sensitivity for NSTEMI early diagnosis, although it with lower speciifcity while increased copeptin level might suggest the patients associated with other clinical conditions such as heart failure or stroke which were important in clinical practice.