Higher cardiac myosin binding protein C levels were independently associated with increased risk of incident CVD (HR 1.25) and cardiovascular death (HR 1.41) in the general population.
Does cardiac myosin binding protein C (cMyC) predict incident cardiovascular disease and mortality in the general population?
Cardiac myosin binding protein C (cMyC) provides strong prognostic information for incident cardiovascular disease in the general population, independent of established cardiac troponins.
Abstract Background Cardiac myosin binding protein C (cMyC) is a cardiac-specific biomarker that is rapidly released after acute ischemic myocardial injury. Cardiac troponins are established cardiac biomarkers for assessment of acute and chronic myocardial injury and provide prognostic information in patients with cardiovascular disease (CVD) and in healthy persons recruited from the general population. There is limited data documenting the prognostic value of cMyC in a general population setting. Purpose To assess the prognostic value of cMyC for incident CVD and mortality in a general population cohort and to contrast these associations with those of cardiac troponin I (cTnI) and T (cTnT). Methods We measured cMyC, cTnI, and cTnT in 3682 community-dwellers born in 1950 at baseline of the Akershus Cardiac Examination (ACE) 1950 Study from 2012 to 2015. We assessed the associations of all three biomarkers with a composite CVD outcome (first event of admission for non-fatal myocardial infarction, non-fatal ischemic stroke, non-fatal heart failure, myocardial revascularization coronary artery bypass grafting or percutaneous revascularization or cardiovascular mortality), as well as with all-cause, cardiovascular, and non-cardiovascular mortality separately. All outcomes were assessed up to December 31, 2022. We demonstrate the associations of cMyC with the outcomes by the Kaplan–Meier estimator and adjusted Cox proportional hazards models. Results The median age was 63.9 (63.4-64.4) years and 1885 (51%) were male. After a median follow-up of 8.3 years, we recorded 302 composite CVD outcomes and 191 deaths. Higher cMyC levels were associated with an increased risk of the composite CVD outcome (Figure), as was cTnI and cTnT. cMyC remained independently associated with incident CVD (hazard ratio per 1 SD in log-transformed cMyC 1.25, 95% CI 1.14 to 1.37) and CV death (hazard ratio per 1 SD in log-transformed cMyC 1.41, 95% CI 1.15 to 1.72) in adjusted analyses and after further adjustment for cTnI or cTnT (Table). Conclusion(s) cMyC provides strong prognostic information for incident CVD in the general population, independently of that provided by cardiac troponins.Figure. Table.
Omland et al. (2025) studied this question. Higher cardiac myosin binding protein C levels were independently associated with increased risk of incident CVD (HR 1.25) and cardiovascular death (HR 1.41) in the general population.