Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction

BACKGROUND:Cardiac myosin-binding protein C (cMyC) is a cardiac-restricted protein that is more abundant than cardiac troponins (cTn) and is released more rapidly after acute myocardial infarction (AMI). We evaluated cMyC as an adjunct or alternative to cTn in the early diagnosis of AMI. METHODS:Uns...

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Published in:Circulation (New York, N.Y.) N.Y.), 2017-10, Vol.136 (16), p.1495-1508
Main Authors: Kaier, Thomas E, Twerenbold, Raphael, Puelacher, Christian, Marjot, Jack, Imambaccus, Nazia, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Sabti, Zaid, Giménez, Maria Rubini, Wildi, Karin, Hillinger, Petra, Grimm, Karin, Loeffel, Sarah, Shrestha, Samyut, Widmer, Dayana Flores, Cupa, Janosch, Kozhuharov, Nikola, Miró, Òscar, Martín-Sánchez, F Javier, Morawiec, Beata, Rentsch, Katharina, Lohrmann, Jens, Kloos, Wanda, Osswald, Stefan, Reichlin, Tobias, Weber, Ekkehard, Marber, Michael, Mueller, Christian
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Area Under Curve
Biomarkers - blood
Carrier Proteins - blood
Early Diagnosis
Emergency Service, Hospital
Europe
Female
Humans
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Original s
Predictive Value of Tests
Prognosis
Reproducibility of Results
ROC Curve
Time Factors
Triage
Troponin I - blood
Troponin T - blood
Up-Regulation
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Summary:BACKGROUND:Cardiac myosin-binding protein C (cMyC) is a cardiac-restricted protein that is more abundant than cardiac troponins (cTn) and is released more rapidly after acute myocardial infarction (AMI). We evaluated cMyC as an adjunct or alternative to cTn in the early diagnosis of AMI. METHODS:Unselected patients (N=1954) presenting to the emergency department with symptoms suggestive of AMI, concentrations of cMyC, and high-sensitivity (hs) and standard-sensitivity cTn were measured at presentation. The final diagnosis of AMI was independently adjudicated using all available clinical and biochemical information without knowledge of cMyC. The prognostic end point was long-term mortality. RESULTS:Final diagnosis was AMI in 340 patients (17%). Concentrations of cMyC at presentation were significantly higher in those with versus without AMI (median, 237 ng/L versus 13 ng/L, P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.117.028084