“…However, these studies were flawed by several limitations including the lack of prospective evaluation in the observational studies with few exceptions (M€ ockel et al 2015(M€ ockel et al , Giannitsis et al 2019, small sample size and low event rates (Meune et al 2011, Bahrmann et al 2013, Sebbane et al 2013, Alqu ezar et al 2017, Morawiec et al 2018, Chenevier-Gobeaux et al 2019, false definition of dual marker testing (i.e. either component positive instead of both components negative (Meune et al 2011, Eggers et al 2012, Sebbane et al 2013, use of the previous less sensitive Copeptin assay formulation, mostly used at a cut-off of 14-17.3 pmol/L (Meune et al 2011, Eggers et al 2012, Bahrmann et al 2013, Sebbane et al 2013, Lipinski et al 2014, Raskovalova et al 2014, Morawiec et al 2018, or 12 pmol/L (Chenevier-Gobeaux et al 2019) instead of the more sensitive cut-off at the 95th percentile at 9 or 10 pmol/L (Thelin et al 2013, M€ ockel et al 2015, Alqu ezar et al 2017, Giannitsis et al 2019, Wildi et al 2019. Moreover, several studies did not exclude patients with persistent ST-segment elevations (Sebbane et al 2013, Lipinski et al 2014, Raskovalova et al 2014.…”