Patented biomarker for cardiac injury. 

cMyC (Cardiac Myosin-binding Protein C)

What is cMyC

Cardiac Myosin-binding Protein C (cMyC), also abbreviated as cMyBP-C, is a structural muscle protein contained within the contractile apparatus of cardiac myocytes[ref].
It acts as a brake to limit cardiac muscle contraction.

It is a 140.5 kDa protein composed of 1273 amino acids.

It regulates the positioning of myosin and actin interaction.
The cardiac isoform of myosin-binding protein C (cMyC) is cardiac-specific.

cMyC is a rapid cardiac specific biomarker

It is a distinctive cardiac necrosis marker[ref] for triaging chest pain patients.
It outperforms existing hs-Troponin assays for early Rule-out of Myocardial Infarction[ref].
The cMyC Algorithm reduces patients in observation groups[ref] => Cost saving for hospitals[ref].

It is suitable as a POC assay as analytical sensitivity is less critical (requires 10 ng/L LOQ)[ref].

cMyC rises faster to detectable levels compared to troponin

cMyC release following cardiac surgical interventions show similar release patterns as Troponin but rises faster to detectable levels[ref].

cMyC rules out more patients faster compared to high sensitivity troponin

1368 patients were presenting to the Emergency Department with symptoms suggestive of Acute Myocardial Infarction[ref]. Using cMyC to triage on first blood draw Rule-out more patients compared with hs-cTnT and hs-cTnI.

cMyC Rule-out AMI with 100% sensitivity and NPV at only 2 hours of chest pain.

A prehospital study with 776 Ambulance patients with a median onset of chest pain of 70 min showed a Rule-out at the  first sample at two hours of chest pain with 100% sensitivity and NPV[ref].

cMyC can reduce the observation group with 18-27% after the first blood sample compared to hs-cTn.

cMyC have demonstrated high diagnostic accuracy for the early detection of non-ST-elevation myocardial infarction (NSTEMI).

Its dynamic release kinetics may enable a 0/1h-decision algorithm that is even more effective than the ESC hs-cTnT/I 0/1 h rule-in/rule-out algorithm.

The cMyC 0/1h-algorithm provided excellent safety and identified a greater proportion of patients suitable for direct rule-out or rule-in based on a single measurement than the ESC 0/1h-algorithm using hs-cTnT/I.[ref].

cMyC requires only 10 ng/L level of detection => suitable for PoC platforms

The cMyC Limit of quantification (LOQ) to rule-out AMI at 10 ng/L is higher when comparing the LOQ needed to rule-out AMI using high sensitivity Troponins (hs-cTnI and hs-cTnT). The 10 ng/L LOQ indicates that cMyC could be a suitable biomarker for PoC platform systems[ref].
This image is the current suggested cMyC 0/1h-algorithm for chest pain patients with suspected AMI[ref].
cMyC 0/1h-algorithm for triaging chest pain patients for AMI (Acute Myocardial Infarction)
cMyC 0/1h-algorithm for triaging chest pain patients for AMI (Acute Myocardial Infarction)

cMyC in the ESC guidelines

cMyC (Cardiac Myosin-binding Protein C) is now mentioned in the ESC guidelines for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation[ref].
“Myosin-binding protein C (cMyC) is more abundant than cardiac troponin and may therefore provide value as an alternative to, or in combination with, cardiac troponin.”

Websites with more information about cMyC