Copeptin plus troponin combo, accurate in ruling out acute myocardial infarction: Study

Medically Reviewed By : Dr. Kamal Kant Kohli

Published On 2022-07-12 14:30 GMT | Update On 2022-07-12 14:30 GMT

USA: In low-to-intermediate risk patients with the suspected acute coronary syndrome, combined negative copeptin and highly sensitive troponin testing resulted in a quick discharge from ICU, states an article published in the Heart Vessels.

Most patients (≈85%) admitted to an emergency department (ED) with the possible acute coronary syndrome do not have an acute myocardial infarction (AMI). A critical and unmet therapeutic need for the prompt and reliable exclusion of acute myocardial infarction (AMI), resulting in the early discharge from the emergency department is required, as 2% to 5% of patients with AMI are discharged mistakenly from the ED, often with severe consequences.

High-sensitivity troponin (HS-TnT) combined with copeptin has been proposed to expedite the diagnostic exclusion of AMI in addition to its predictive usefulness in the intermediate and long-term outcomes of AMI. Global Registry of Acute Coronary Events (GRACE) is recommended as a prognostic score to manage acute coronary syndrome (ACS) without ST-segment elevation.

Sheref A. Elseidy, Rochester General Hospital, Rochester, USA, and colleagues conducted a systematic review to compare the diagnostic accuracy of HS-TnT combined with copeptin in ruling out AMI compared to HS-TnT alone.

Researchers included nine studies with a total of 13,232 participants for the review. They combined a low GRACE score (108) with negative HS-TnT (14 ng/L) and copeptin (14 pmol/L) to reliably rule out non-ST and ACS, including non-ST segment elevation MI and unstable angina.

Key findings of the review:

• The negative predictive value (NPV) for copeptin and HS-TnT was found to be slightly higher in combination (62–99%) than for HS-TnT alone (60–99%)

• The sensitivity of copeptin ranged from 0% to 100%, with a pooled sensitivity of 0.79.

• The specificity of copeptin ranged from 13% to 100%, with a pooled specificity of 0.89, a pooled positive likelihood ratio (PLR) of 9.86, and a pooled negative likelihood ratio (NLR) of 0.08.

The authors conclude that the use of combined negative copeptin and highly sensitive troponin testing in low-to-intermediate risk patients with suspected acute coronary syndrome results in a quick discharge with a safe and rapid rule-out non-ST and ACS.

Reference:

Elseidy, S.A., Awad, A.K., Mandal, D. et al. Copeptin plus troponin in the rapid rule out of acute myocardial infarction and prognostic value on post-myocardial infarction outcomes: a systematic review and diagnostic accuracy study. Heart Vessels (2022). https://doi.org/10.1007/s00380-022-02123-x

Article Source : Heart Vessels

Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.

NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.

Dr. Hiral patel

Dr. Hiral patel (BDS) has completed BDS from Gujarat University, Baroda. She has worked in private dental steup for 8years and is currently a consulting general dentist in mumbai. She has recently completed her advanced PG diploma in clinical research and pharmacovigilance. She is passionate about writing and loves to read, analyses and write informative medical content for readers. She can be contacted at editorial@medicaldialogues.in.

Comments Policy

Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .

Copeptin plus troponin combo, accurate in ruling out acute myocardial infarction: Study

Similar News

Injectable therapy could prevent heart failure after a heart attack: Study

Alteplase May Improve Outcomes When Given 4.5-24 Hours After Stroke in Select Patients: JAMA

Women who have been stalked may have higher risk of heart disease, stroke, reports study

Heart Failure in Women: Updates from the National Consensus on Bisoprolol

No Clear Winner: Three Dual-Drug Hypertension Therapies Work Equally Well in Indian Adults, TOPSPIN Trial Finds

5 Lifestyle Habits May Cut Heart Disease Risk by 86 Percent in Women with Gestational Diabetes: Study Finds

Severe Gum Disease Strongly Linked to Chronic Illnesses, Large U.S. Study Finds

Fetal Embolization Exhibits Early Success in High-Risk Vein of Galen Malformation: JAMA