Cardiac myosin-binding protein C: potential early biomarker of myocardial injury in coronary artery bypass surgery

BACKGROUND: In this study, it was aimed to evaluate the diagnostic value of myosin binding protein C (cMyBP-C) as a new cardiac injury marker in demonstrating myocardial injury in Coronary Artery Bypass Surgery patients. METHODS: Prospectively collected data from 60 coronary artery bypass surgery patients were evaluated and the results were compared. The study included 60 patients who applied to the Cardiovascular Surgery Clinic between March 2024 and September 2024 and who were going to undergo coronary bypass surgery. The patients' high-sensitivity cardiac troponin T (hs-cTnT) and Cardiac myosin binding protein C (cMyBP-C) levels, clinical and descriptive information were analyzed before the bypass procedure, after the cross clamp and at the sixth hour post-operation. RESULTS: Area under curve (AUC) for cMyBP-C for Length of ICU stay was 0.673, whereas AUC mean for hs-cTnT was 0.590. For cMyBP-C preop cut off level at 4836.50, sensitivity was 66.7% and specificity was 22.2%. Preoperative cMyBP C was significantly correlated with HT(r=-0,299; p < 0.05), DM (r=-0.350; p < 0.01), cardiopulmonary bypass time (CPB) time (r=-0.339; p < 0.01), and preop lactate (0.349; p < 0.01). Postoperative cMyBP-C level was significantly correlated with HT(r=-0.320; p < 0.05), DM (r=-0.462; p < 0.01), Perioperative lactate (r = 0.277; p < 0.05) and lactate at 6th hour (r = 0.280; p < 0.05). DM (B = 2602.92; p < 0.01), Length of hospital stay (B = 254.83; p < 0.05) and ascending aorta with (B = 249.50; p < 0.05) positively association with perioperative cMyBP-C levels. CONCLUSION: The cMyBP-C biomarker may be an alternative biomarker for myocardial injury in cases where high hs-cTnT levels are insufficient to indicate myocardial injury. DM should be considered as an important and determining variable in myocardial injury, including hs-cTnT.