Observational studyJournal of the American Heart Association2025
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.
Observational study in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06128317 (Cardiac Biochemical and Omics-based Biomarkers in Patients Presenting Symptoms of Acute Coronary Syndrome in the Emergency Department), which is not on this map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Cardiac Biochemical and Omics-based Biomarkers in Patients Presenting Symptoms of Acute Coronary Syndrome in the Emergency Department (ACS Registry)
Who cites it
12 citing papers in PubMed.
- Type 1 and type 2 NSTEMI in atrial fibrillation: insights from the HERA-FIB registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- 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
- Association of cholesterol, high-density lipoprotein, and glucose index and modified indices in predicting cardiovascular diseases incidence among population with cardiovascular-kidney-metabolic syndrome stages 0-3: a nationwide prospective cohort study.BMC cardiovascular disorders · 2026Article
- Elevated plasma TMAO levels associated with all-cause mortality in CAD patients in South China.BMC cardiovascular disorders · 2026Observational
- Association of routine inflammatory biomarkers and derived indices with heart failure progression in preserved ejection fraction.BMC cardiovascular disorders · 2026Article
- Sex-specific non-linear association between post-procedural high-sensitivity troponin t and 12-month mortality after PCI: insights from a prospective large-scale registry.BMC cardiovascular disorders · 2026Article
- CDK7 as a Potential Exploratory Biomarker for Distinguishing Acute Myocardial Infarction Subtypes via DDR Pathways: Evidence From a Bangladeshi Cohort.Clinical cardiology · 2026Article
- The Incremental Value of Copeptin for the Early Rule-Out of Non-ST Elevation Myocardial Infarction in the Emergency Department.Journal of clinical medicine · 2026Article
- Cardiac biomarkers in women with high-risk pregnancies: short-term outcomes from the Heidelberg Cardio-Obstetrics Registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Relationship between cardiac troponin and myocardial infarction: a bibliometric analysis.Journal of cardiothoracic surgery · 2026Article
- Diagnostic challenges in acute coronary syndrome: reconciling the STEMI-NSTEMI and OMI-NOMI paradigms.BMC cardiovascular disorders · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study compared the diagnostic and prognostic performance of various non-ST-segment myocardial infarction (NSTEMI) rule-out protocols, incorporating cardiac myosin-binding protein C (cMyBP-C), high-sensitivity cardiac troponin T (hs-cTnT), and Copeptin, both individually and as part of dual-marker strategies (DMSs) against the European Society of Cardiology 0/1-hour and 0/3-hour algorithms.
methodsWe enrolled 1765 patients presenting to the emergency department with suspected NSTEMI. We evaluated biomarker algorithms including cMyBP-C (<10 ng/L, <2.3 ng/L), hs-cTnT (limit of blank [<3 ng/L], limit of detection [<5 ng/L], 99th percentile [≤14 ng/L]), and DMS combinations of copeptin (<10 pmol/L) with hs-cTnT, cMyBP-C with hs-cTnT, and copeptin with cMyBP-C. The European Society of Cardiology 0/1-hour and 0/3-hour algorithms were also tested. We calculated negative predictive values and sensitivities for NSTEMI rule-out and assessed effectiveness and prognostic performance based on cardiovascular events within 30 days and 1 year.
resultsThe areas under the curve were 0.922 for hs-cTnT, 0.917 for cMyBP-C, and 0.624 for copeptin in diagnosing NSTEMI. DMS protocols showed negative predictive values of 99.1% to 100%, comparable with the European Society of Cardiology algorithms (99.3%-100%). Sensitivities for DMS ranged from 96.2% to 100%. All protocols had low rates of the combined end point of cardiovascular events within 30 days (0.0%-0.6%).
conclusionsThe European Society of Cardiology 0/1-hour algorithm and DMS combining hs-cTnT with either cMyBP-C or copeptin provide highly reliable and safe protocols for NSTEMI rule-out. These DMS approaches offer promising alternatives to current standards, potentially improving clinical decision making and efficiency in emergency departments. REGISTRATION: URL: https://clinicaltrials.gov; Unique identifier: NCT06128317.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.