What question did this study set out to answer?

To prospectively determine whether combining copeptin with high-sensitivity cardiac troponin T at baseline improves the early rule-out of non-ST-segment elevation myocardial infarction.

August 1, 2011Clinical ChemistryOpen Access

Combined Testing of High-Sensitivity Troponin T and Copeptin on Presentation at Prespecified Cutoffs Improves Rapid Rule-Out of Non–ST-Segment Elevation Myocardial Infarction

View Full Paper

Ask AI

Bookmark

Why the study?

Does combined testing of copeptin and hscTnT at prespecified cutoffs improve the rapid rule-out of non-STEMI in patients with suspected acute coronary syndrome compared to hscTnT alone?

Population

503 patients with suspected acute coronary syndrome and onset of chest pain occurring within the previous 12…

Comparison

Combined testing of copeptin and… vs High-sensitivity cardiac troponin T (hscTnT) alone

Design

Cohort

Follow-up

6 hours (serial measurements at baseline, 3, and 6 h)

Authors

EGEvangelos GiannitsisGeneral Cardiology TKTzveta KehayovaHeidelberg University MVMehrshad VafaieHeidelberg University

Discussion

Member takes

Implication

May support early non-STEMI rule-out in suspected ACS; leaves open superiority over hscTnT alone pending prospective validation.

Key Points

To prospectively determine whether combining copeptin with high-sensitivity cardiac troponin T at baseline improves the early rule-out of non-ST-segment elevation myocardial infarction.
Enrolled 503 patients presenting with suspected acute coronary syndrome and chest pain onset within the preceding 12 hours.
Measured copeptin at presentation and high-sensitivity cardiac troponin T (hscTnT) serially at baseline, 3 hours, and 6 hours.
Evaluated diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and ROC curves for single and combined marker cutoffs.
Combining baseline hscTnT <14 ng/L and copeptin <14 pmol/L ruled out non-STEMI with a diagnostic sensitivity of 97.7% (95% CI, 91.9%-99.7%) and an NPV of 99.03% (95% CI, 96.6%-99.9%).
The dual-biomarker strategy yielded a specificity of 55.9% (95% CI, 50.6%-61.0%) and a PPV of 34.4% (95% CI, 28.5%-40.7%).
Continuous ROC curve analysis showed no added diagnostic value for the combined markers over hscTnT alone when hscTnT served as the reference standard.

Structured PICO

Does combined testing of copeptin and hscTnT at prespecified cutoffs improve the rapid rule-out of non-STEMI in patients with suspected acute coronary syndrome compared to hscTnT alone?

Population

503 patients with suspected acute coronary syndrome and onset of chest pain occurring within the previous 12 hours

Intervention

Combined testing of copeptin (measured on presentation) and high-sensitivity cardiac troponin T (hscTnT) at prespecified cutoffs (hscTnT <14 ng/L and copeptin <14 pmol/L)

Comparator

High-sensitivity cardiac troponin T (hscTnT) alone

Outcome

Diagnostic performance (sensitivity, specificity, negative predictive value, positive predictive value) for ruling out non-STEMIsurrogate

Combined testing of copeptin and hscTnT at prespecified cutoffs provides high sensitivity and negative predictive value for the rapid rule-out of non-STEMI in patients with suspected acute coronary syndrome.

Cite This Study

Giannitsis et al. (2011) studied this question.

synapsesocial.com/papers/69fd27cc18019853544902a8 https://doi.org/10.1373/clinchem.2010.161265

View Full Paper

Ask AI

Bookmark

Combined Testing of High-Sensitivity Troponin T and Copeptin on Presentation at Prespecified Cutoffs Improves Rapid Rule-Out of Non–ST-Segment Elevation Myocardial Infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Combined Testing of High-Sensitivity Troponin T and Copeptin on Presentation at Prespecified Cutoffs Improves Rapid Rule-Out of Non–ST-Segment Elevation Myocardial Infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider