Prognostic Value of Cardiac Myosin Binding Protein C in the General Population: The Akershus Cardiac Examination 1950
Torbjørn Omland1,2, Michael Paus1,2, Arnljot Tveit3,4
1Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
Insights
Cardiac myosin binding protein C (cMyC) predicts cardiovascular events in the general population. This biomarker offers prognostic value for major adverse cardiovascular events (MACE) and mortality, independent of cardiac troponins.
Area of Science:
- Cardiology
- Biomarker Research
- Preventive Medicine
Background:
- Cardiac myosin binding protein C (cMyC) is a cardiac biomarker released during myocardial injury.
- Cardiac troponins are established biomarkers for myocardial injury and prognosis in cardiovascular disease (CVD).
- Limited data exists on the prognostic value of cMyC in the general population.
Purpose of the Study:
- To assess the prognostic value of cMyC for incident major adverse cardiovascular events (MACE) and mortality in a general population.
- To compare the prognostic associations of cMyC with those of cardiac troponins.
Main Methods:
- Serum samples from 3682 community dwellers (born 1950) were analyzed for cMyC, hs-cTnI, and hs-cTnT.
- Associations with a composite MACE outcome and mortality (all-cause, cardiovascular, non-cardiovascular) were assessed.
- Follow-up median duration was 8.3 years.
Main Results:
- cMyC, hs-cTnI, and hs-cTnT were all associated with the risk of MACE (P <0.001).
- cMyC independently predicted MACE (HR 1.25) and cardiovascular death (HR 1.41) after adjustment for troponins.
- 307 MACE outcomes and 191 deaths were recorded during follow-up.
Conclusions:
- cMyC provides significant prognostic information for incident CVD in the general population.
- The prognostic value of cMyC is independent of cardiac troponin levels.
Background:
Cardiac myosin binding protein C (cMyC) is a cardiac-specific biomarker that is released after acute ischemic myocardial injury. Cardiac troponins are established cardiac biomarkers of myocardial injury and provide prognostic information in patients with cardiovascular disease (CVD) and in healthy persons from the general population. There is limited data documenting the prognostic value of cMyC in a general population setting. Accordingly, we assessed the prognostic value of cMyC for incident major adverse cardiovascular events (MACE) and mortality in a general population cohort and contrasted these associations with those of cardiac troponins.
Methods:
We measured cMyC, high-sensitivity cardiac troponin I (hs-cTnI), and high-sensitivity T (hs-cTnT) in serum samples from 3682 community dwellers born in 1950 at the baseline of the Akershus Cardiac Examination 1950 Study obtained from 2012 to 2015. We assessed the associations of all three biomarkers with a composite MACE outcome (nonfatal myocardial infarction, nonfatal ischemic stroke, nonfatal heart failure, myocardial revascularization, or cardiovascular mortality), as well as with all-cause, cardiovascular and non-cardiovascular mortality separately.
Results:
The median age was 63.9 years and 1885 were male. After a median follow-up of 8.3 years, we recorded 307 composite MACE outcomes and 191 deaths. cMyC was associated with risk of MACE, as was hs-cTnI and hs-cTnT (all P for log-rank test <0.001). cMyC remained independently associated with MACE (hazard ratio per 1 SD in log-transformed biomarker 1.25, 95% CI, 1.14-1.37) and cardiovascular death (hazard ratio 1.41, 95% CI 1.15-1.72) in adjusted analyses and after further adjustment for hs-cTnI or hs-cTnT.
Conclusions:
cMyC provides strong prognostic information for incident CVD in the general population, independently of that provided by cardiac troponins.
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