Prognostic value of copeptin in patients with acute coronary syndrome: A systematic review and meta-analysis

BACKGROUND: 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). METHODS: 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 I(2) index were used to assess between-study heterogeneity, and Deek’s test and funnel plots were used to assess publication bias. RESULTS: 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; I(2) = 69.76%) and specificity (P<0.001; I(2) = 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. CONCLUSIONS: 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.