Importance
Rapid and accurate noninvasive discrimination of type 2 myocardial infarction (T2MI), which is because of a supply-demand mismatch, from type 1 myocardial infarction (T1MI), which arises via plaque rupture, is essential, because treatment differs substantially.
Unfortunately, this is a major unmet clinical need, because even high-sensitivity cardiac troponin (hs-cTn) measurement provides only modest accuracy.
Conclusions and relevance
In this study, biomarkers quantifyingmyocardial injury, endothelial dysfunction, microvascular dysfunction, and/or hemodynamic stress provided modest discrimination in early, noninvasive diagnosis of T2MI.
cMyC related data of interest
cMyC concentrations, which may quantify cardiomyocyte injury even more accurately than hs-cTnT or hs-cTnI levels,1,2,3 were lower in T2MI vs T1MI and provided modest diagnostic accuracy, comparable with that provided by hs-cTnT and hs-cTnI.
1: Kaier TE, Twerenbold R, Puelacher C, et al. Direct comparison of cardiacmyosin-binding protein c with cardiac troponins for the early diagnosis of acutemyocardial infarction. Circulation. 2017;136(16):1495-1508. doi:10.1161/CIRCULATIONAHA.117.028084
2: Baker JO, Tyther R, Liebetrau C, et al. Cardiac
myosin-binding protein C: a potential early biomarker ofmyocardial injury. Basic Res Cardiol. 2015;110(3):23. doi:10.1007/s00395-015-0478-5
3. Kaier TE, Anand A, Shah ASV, Mills NL, Marber M. Temporal relationship between cardiac myosin-binding protein C and cardiac troponin I in
type 1myocardial infarction. Clin Chem. 2016;62(8):
1153-1155. doi:10.1373/clinchem.2016.257188
