ArticleEuropean heart journal. Acute cardiovascular care2022
A 0/1h-algorithm using cardiac myosin-binding protein C for early diagnosis of myocardial infarction.
Article in European heart journal. Acute cardiovascular care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00470587 (Advantageous Predictors of Acute Coronary Syndromes Evaluation), which is not on this map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Advantageous Predictors of Acute Coronary Syndromes Evaluation (APACE) Study
Who cites it
14 citing papers in PubMed, 15 citations in OpenAlex.
- Occlusion myocardial infarction in type I NSTEMI: prevalence, characteristics, management, and long-term outcome.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Cardiac Myosin-Binding Protein C in Suspected Acute Coronary Syndrome: From Sarcomeric Injury Biology to Decision-Grade Risk Stratification.International journal of molecular sciences · 2026Review
- Cardiac myosin-binding protein C in ST-elevation myocardial infarction.European heart journal. Acute cardiovascular care · 2026Article
- Prognostic value of point-of-care testing for cardiac myosin-binding protein C in early risk assessment of acute myocardial infarction: a prospective cohort study.Scientific reports · 2026Article
- Article
- Review
- Cardiac myosin-binding protein-C levels are associated with severity and prognosis in stable coronary artery disease.Scientific reports · 2025Article
- Emergency Department Implementation of a Multimodal Electronic Health Record-Integrated Clinical Intervention for High-Sensitivity Troponin Testing Increases Diagnostic Efficiency.Journal of the American College of Emergency Physicians open · 2025Article
- Prognostic value of combining cardiac myosin-binding protein C and N-terminal pro-B-type natriuretic peptide in patients without acute coronary syndrome treated at medical cardiac intensive care units.Heart and vessels · 2025Article
- Using higher cut-off values to diagnose acute myocardial infarction in patients with elevated hs-cTnT.Journal of biomedical research · 2025Article
- Comparative Analysis of Single- and Dual-Marker Strategies for Rapid Non-ST-Segment-Elevation Myocardial Infarction Rule-Out Using Cardiac Myosin-Binding Protein C, Copeptin, and High-Sensitivity Cardiac Troponin T in the Emergency Department.Journal of the American Heart Association · 2025Observational
- Diagnostic and Prognostic Evaluation of Novel Biomarkers Compared to ESC 0/1 h and 0/3 h Algorithms in Patients with Suspected Non-ST-Elevation Myocardial Infarction.Journal of clinical medicine · 2025Article
- Comparing the utility of clinical risk scores and integrated clinical judgement in patients with suspected acute coronary syndrome.European heart journal. Acute cardiovascular care · 2023Article
- Serial measurements of protein and microRNA biomarkers to specify myocardial infarction subtypes.Journal of molecular and cellular cardiology plus · 2022Article
Corrections and comments
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Authors and funding
22 authors at 6 institutions in 6 countries.
Funding
Abstract
aimsCardiac myosin-binding protein C (cMyC) demonstrated high diagnostic accuracy for the early detection of non-ST-elevation myocardial infarction (NSTEMI). Its dynamic release kinetics may enable a 0/1h-decision algorithm that is even more effective than the ESC hs-cTnT/I 0/1 h rule-in/rule-out algorithm. METHODS AND
resultsIn a prospective international diagnostic study enrolling patients presenting with suspected NSTEMI to the emergency department, cMyC was measured at presentation and after 1 h in a blinded fashion. Modelled on the ESC hs-cTnT/I 0/1h-algorithms, we derived a 0/1h-cMyC-algorithm. Final diagnosis of NSTEMI was centrally adjudicated according to the 4th Universal Definition of Myocardial Infarction. Among 1495 patients, the prevalence of NSTEMI was 17%. The optimal derived 0/1h-algorithm ruled-out NSTEMI with cMyC 0 h concentration below 10 ng/L (irrespective of chest pain onset) or 0 h cMyC concentrations below 18 ng/L and 0/1 h increase <4 ng/L. Rule-in occurred with 0 h cMyC concentrations of at least 140 ng/L or 0/1 h increase ≥15 ng/L. In the validation cohort (n = 663), the 0/1h-cMyC-algorithm classified 347 patients (52.3%) as 'rule-out', 122 (18.4%) as 'rule-in', and 194 (29.3%) as 'observe'. Negative predictive value for NSTEMI was 99.6% [95% confidence interval (CI) 98.9-100%]; positive predictive value 71.1% (95% CI 63.1-79%). Direct comparison with the ESC hs-cTnT/I 0/1h-algorithms demonstrated comparable safety and even higher triage efficacy using the 0h-sample alone (48.1% vs. 21.2% for ESC hs-cTnT-0/1 h and 29.9% for ESC hs-cTnI-0/1 h; P < 0.001).
conclusionThe cMyC 0/1h-algorithm provided excellent safety and identified a greater proportion of patients suitable for direct rule-out or rule-in based on a single measurement than the ESC 0/1h-algorithm using hs-cTnT/I.
trial registrationClinicalTrials.gov number, NCT00470587.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.