Key result
cMyC 0/1h-algorithm more than doubles early triage efficacy at presentation compared with ESC hs-cTnT.
Why the study?
Cardiac myosin-binding protein C (cMyC) may enable a 0/1h-decision algorithm for early NSTEMI diagnosis that could be more effective than the ESC hs-cTnT/I 0/1h algorithms.
Does a 0/1h-algorithm using cardiac myosin-binding protein C improve early diagnosis of NSTEMI compared to the ESC hs-cTnT/I 0/1h-algorithms in patients presenting with suspected NSTEMI?
Population
1495 patients presenting with suspected NSTEMI to the emergency department
Comparison
0/1h-cMyC-algorithm vs ESC hs-cTnT/I 0/1h-algorithms
Design
Prospective international diagnostic study with blinded cMyC measurement
Follow-up
1 hour
Authors
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May support faster early triage in suspected NSTEMI; hypothesis-generating and requires prospective validation before practice change.
Observational (n=2,158)
Blinded
Yes
Does a 0/1h-algorithm using cardiac myosin-binding protein C improve early diagnosis of NSTEMI compared to the ESC hs-cTnT/I 0/1h-algorithms in patients presenting with suspected NSTEMI?
Absolute Event Rate: 48.1% vs 21.2%
p-value: p=< 0.001
A 0/1h algorithm using cardiac myosin-binding protein C provides excellent safety and higher triage efficacy for early rule-out or rule-in of NSTEMI compared to the standard ESC hs-cTnT/I algorithms.
Kaier et al. (2022) conducted an observational in Suspected non-ST-elevation myocardial infarction (NSTEMI) (n=2,158). 0/1h-algorithm using cardiac myosin-binding protein C (cMyC) vs. ESC hs-cTnT/I 0/1h-algorithms was evaluated on Triage efficacy using the 0h-sample alone (p=< 0.001). A 0/1h-algorithm using cardiac myosin-binding protein C demonstrated higher triage efficacy using the 0h-sample alone compared to the ESC hs-cTnT 0/1h-algorithm (48.1% vs. 21.2%; P < 0.001).
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