Author + information
- Thomas Edward Kaiera,b,
- Carsten Stengaarda,b,
- Jack Marjota,b,
- Jacob Sorensena,b,
- Stavroula Stavropoulou-Tatlaa,b,
- Christian Terkelsena,b,
- Kristian Thygesena,b,
- Michael Marbera,b and
- Hans Botkera,b
Background: Cardiac myosin binding protein C (cMyC) is a cardiac-restricted protein that is more abundant than Troponin T (cTnT) and is released rapidly following Acute Myocardial Infarction (AMI). We evaluated the performance of cMyC vs hs-cTnT for diagnosis of AMI in very early presenters.
Methods: cMyC (Singulex) and hs-cTnT (Roche Elecsys) were measured in blood samples obtained during ambulance transfer of 776 patients with symptoms suggestive of AMI. The area under the receiver-operating curve (AUC [95% confidence interval]) determined diagnostic accuracy against adjudicated AMI. Correlation assessed with Spearman's (rs) and adjusted R2 fitting a linear regression model.
Results: Concentrations of cMyC at 0h were significantly higher in AMI (n=173 [22%]; median 98ng/L [IQR 43-855] vs 17ng/L [IQR 9-42], p <0.001). Median time since onset of chest pain: 70mins [35-175]. Diagnostic accuracy of cMyC was better than hs-cTnT: AUC 0.839 [95% CI, 0.805-0.872] vs 0.8 [0.761-0.838]. Combination of both markers: AUC 0.823 [0.788-0.857]. In this cohort, the 99th centile of hs-cTnT (14ng/L) achieved a sensitivity of 80% and specificity of 65%, vs cMyC (87ng/L) of 56% and 86%, respectively. The biomarkers correlated strongly: R2=0.73, rs=0.86 for all patients, R2=0.7, rs=0.93 for AMI.
Conclusions: cMyC correlates strongly with the established gold-standard, however the novel biomarker demonstrates greater diagnostic accuracy in the very early phase of an acute coronary event.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-321
- 2017 American College of Cardiology Foundation