Performance of Copeptin for Early Diagnosis of Acute Coronary Syndromes: A Systematic Review and Meta-Analysis of 14,139 Patients

Abstract

Diagnosis of acute coronary syndrome (ACS) based on copeptin level may enable one to confirm or rule-out acute myocardial infarction (AMI) with higher sensitivity and specificity, which may in turn further reduce mortality rate and decrease the economic costs of ACS treatment. We conducted a systematic review and meta-analysis to investigate the relationship between copeptin levels and type of ACS. We searched Scopus, PubMed, Web of Science, Embase, and Cochrane to locate all articles published up to 10 October 2021. We evaluated a meta-analysis with random-effects models to evaluate differences in copeptin levels. A total of 14,139 patients (4565 with ACS) were included from twenty-seven studies. Copeptin levels in AMI and non-AMI groups varied and amounted to 68.7 ± 74.7 versus 14.8 ± 19.9 pmol/L (SMD = 2.63; 95% CI: 2.02 to 3.24; p < 0.001). Copeptin levels in the AMI group was higher than in the unstable angina (UAP) group, at 51.9 ± 52.5 versus 12.8 ± 19.7 pmol/L (SMD = 1.53; 95% CI: 0.86 to 2.20; p < 0.001). Copeptin levels in ST-elevation myocardial infarction (STEMI) versus non-ST elevation myocardial infarction (NSTEMI) patient groups were 54.8 ± 53.0 versus 28.7 ± 46.8 pmol/L, respectively (SMD = 1.69; 95% CI: = 0.70 to 4.09; p = 0.17). In summary, elevated copeptin levels were observed in patients with ACS compared with patients without ACS. Given its clinical value, copeptin levels may be included in the assessment of patients with ACS as well as for the initial differentiation of ACS.

Systematic review and meta-analysis of intravenous and topical tranexamic acid in reducing blood loss in knee arthroplasty

“…A random-effects model was used to pool study results independently of the p-value for heterogeneity or I2 [29]. All the p-values are two-sided, and a p < 0.05 was considered statistically significant [30].…”

Association between Copeptin and Metabolic Syndrome: A Systematic Review

“…The role of copeptin as an early diagnosis surrogate marker of acute coronary syndrome and as a prognostic factor for acute myocardial infarction has been observed [ 35 ], as well as its predictive value for assessing the risk of mortality in heart failure [ 36 , 37 ]. It has also been reported to be involved in the pathogenesis of diabetes mellitus [ 28 ] and its micro and macrovascular complications [ 38 ].…”

“…It has also been reported to be involved in the pathogenesis of diabetes mellitus [ 28 ] and its micro and macrovascular complications [ 38 ]. The pathogenesis pathways of the aforementioned associations are interrelated with the pathophysiological pathways of MetS, which in turn increases the risk of cardiovascular events [ 28 , 35 , 36 , 38 ]. Thus, strategies based on routine copeptin measurements could help to detect early metabolic disorders in progress related to AVP pathway disorders.…”

Diagnostic and prognostic performance of the neutrophil-to-lymphocyte ratio in acute coronary syndromes: A meta-analysis of 90 studies including 45 990 patients

“…Many mechanisms related to the functioning of the immune system have been well described in the development of atherosclerosis and atherothrombosis [9,10]. Macrophages and T lymphocytes are involved in the process of formation and development of atherosclerotic plaque.…”