National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
PLoS One. 2020 Aug 28;15(8):e0238288. doi: 10.1371/journal.pone.0238288. eCollection 2020.
The aim of this study was to evaluate the value of copeptin in predicting mortality including both short-term and long-term mortality in patients with acute coronary syndrome (ACS).
Potential studies were searched and selected through PubMed, Embase and Cochrane databases up to December 2019. The predictive performance was evaluated by the pooled sensitivity and specificity, and summary receiver operating characteristic curves. Cochran's Q test and I2 index were used to assess between-study heterogeneity, and Deek's test and funnel plots were used to assess publication bias.
Total six studies comprising 2269 patients were included in this meta-analysis. The area under the receiver operating characteristic curve of copeptin in predicting mortality in patients with ACS was 0.73 (95% CI: 0.69-0.77). The pooled sensitivity and specificity of copeptin were 0.77 (95% CI: 0.59-0.89) and 0.60 (95% CI: 0.47-0.71), respectively. Significant between-study heterogeneity was identified in both sensitivity (P = 0.01; I2 = 69.76%) and specificity (P<0.001; I2 = 97.32%) among the six included studies. The meta-regression analysis indicated that the number of study centers was significantly associated with the heterogeneity of sensitivity (P = 0.03), whereas the study design (P = 0.03) and duration of follow-up (P<0.001) were significantly associated with the heterogeneity of specificity.
Copeptin has acceptable prognostic value for mortality in patients with ACS. Further studies based on multimarker strategy are needed to evaluate the prognostic value of copeptin for ACS in conjunction with other well-established biomarkers.
本研究旨在评估 copeptin 在预测急性冠状动脉综合征（ACS）患者短期和长期死亡率方面的价值。
通过 PubMed、Embase 和 Cochrane 数据库检索并选择潜在的研究，检索时间截至 2019 年 12 月。通过汇总敏感性和特异性以及汇总受试者工作特征曲线来评估预测性能。采用 Cochran's Q 检验和 I2 指数评估研究间异质性，采用 Deek's 检验和漏斗图评估发表偏倚。
本荟萃分析共纳入 6 项研究，共计 2269 例患者。c肽在预测 ACS 患者死亡率方面的受试者工作特征曲线下面积为 0.73（95%CI：0.69-0.77）。c肽的汇总敏感性和特异性分别为 0.77（95%CI：0.59-0.89）和 0.60（95%CI：0.47-0.71）。在 6 项纳入研究中，敏感性（P=0.01；I2=69.76%）和特异性（P<0.001；I2=97.32%）均存在显著的研究间异质性。meta 回归分析表明，研究中心数量与敏感性异质性显著相关（P=0.03），而研究设计（P=0.03）和随访时间（P<0.001）与特异性异质性显著相关。
c肽对 ACS 患者死亡率具有可接受的预后价值。需要进一步开展基于多标志物策略的研究，以评估 copeptin 与其他已确立的生物标志物联合用于 ACS 预后的预测价值。
