Background
Early triage is essential to improve outcomes in patients with suspected acute myocardial infarction (AMI). This study investigated whether cMyC (cardiac myosin‐binding protein), a novel biomarker of myocardial necrosis, can aid early diagnosis of AMI and risk stratification.
What is New?
In an observational, prospective diagnostic cohort study that included 776 individuals presenting with chest pain and suspected acute myocardial infarction (AMI), cMyC (cardiac myosin‐binding protein C) concentrations in blood draws obtained in the ambulance were significantly higher in patients with AMI than with other diagnoses.
Discrimination power was significantly better for cMyC than for high‐sensitivity cardiac troponin T, and cMyC at the previously published threshold of 10 ng/L for rule‐out of AMI reached 100% sensitivity and negative predictive value in patients with only 2 hours of symptoms.
Discrimination power was significantly better for cMyC than for high‐sensitivity cardiac troponin T, and cMyC at the previously published threshold of 10 ng/L for rule‐out of AMI reached 100% sensitivity and negative predictive value in patients with only 2 hours of symptoms.
What Are the Clinical Implications?
cMyC could significantly improve the early triage of patients with suspected AMI.
We have developed a diagnostic nomogram, translating the combination of clinical risk factors and cMyC concentration into a personalized probability of AMI.
We have developed a diagnostic nomogram, translating the combination of clinical risk factors and cMyC concentration into a personalized probability of AMI.
Conclusions
In patients undergoing blood draws very early after symptom onset, cMyC demonstrates improved diagnostic discrimination of AMI and could significantly improve the early triage of patients with suspected AMI.