Cardiac myosin-binding protein C in the diagnosis and risk stratification of acute heart failure

Kozhuharov, Nikola and Wussler, Desiree and Kaier, Thomas and Strebel, Ivo and Shrestha, Samyut and Flores, Dayana and Nowak, Albina and Sabti, Zaid and Nestelberger, Thomas and Zimmermann, Tobias and Walter, Joan and Belkin, Maria and Michou, Eleni and Lopez Ayala, Pedro and Gualandro, Danielle M. and Keller, Dagmar I. and Goudev, Assen and Breidthardt, Tobias and Mueller, Christian and Marber, Michael and Basel V. Investigators, . (2021) Cardiac myosin-binding protein C in the diagnosis and risk stratification of acute heart failure. European journal of heart failure, 23 (5). pp. 716-725.

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Cardiac myosin-binding protein C (cMyC) seems to be even more sensitive in the quantification of cardiomyocyte injury vs. high-sensitivity cardiac troponin, and may therefore have diagnostic and prognostic utility.; In a prospective multicentre diagnostic study, cMyC, high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) plasma concentrations were measured in blinded fashion in patients presenting to the emergency department with acute dyspnoea. Two independent cardiologists centrally adjudicated the final diagnosis. Diagnostic accuracy for acute heart failure (AHF) was quantified by the area under the receiver operating characteristic curve (AUC). All-cause mortality within 360 days was the prognostic endpoint. Among 1083 patients eligible for diagnostic analysis, 51% had AHF. cMyC concentrations at presentation were higher among AHF patients vs. patients with other final diagnoses [72 (interquartile range, IQR 39-156) vs. 22 ng/L (IQR 12-42), P < 0.001)]. cMyC's AUC was high [0.81, 95% confidence interval (CI) 0.78-0.83], higher than hs-cTnT's (0.79, 95% CI 0.76-0.82, P = 0.081) and lower than NT-proBNP's (0.91, 95% CI 0.89-0.93, P < 0.001). Among 794 AHF patients eligible for prognostic analysis, 28% died within 360 days; cMyC plasma concentrations above the median indicated increased risk of death (hazard ratio 2.19, 95% CI 1.66-2.89; P < 0.001). cMyC's prognostic accuracy was comparable with NT-proBNP's and hs-cTnT's. cMyC did not independently predict all-cause mortality when used in validated multivariable regression models. In novel multivariable regression models including medication, age, left ventricular ejection fraction, and discharge creatinine, cMyC remained an independent predictor of death and had no interactions with medical therapies at discharge.; Cardiac myosin-binding protein C may aid physicians in the rapid triage of patients with suspected AHF.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
UniBasel Contributors:Kozhuharov, Nikola and Wussler, Desiree and Strebel, Ivo and Shrestha, Samyut and Müller, Christian
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:31 Mar 2022 14:07
Deposited On:18 Mar 2022 13:44

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