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Am J Cardiol. 2017 Nov 1;120(9):1501-1507. doi: 10.1016/j.amjcard.2017.07.042. Epub 2017 Jul 31.

Usefulness of Released Cardiac Myosin Binding Protein-C as a Predictor of Cardiovascular Events.

Author information

1
Department of Medical Physiology, Texas A&M University Health Science Center College of Medicine, Temple, Texas; Baylor Scott & White Health-Central Texas, Internal Medicine/Cardiology Division, Temple, Texas.
2
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
3
Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, Illinois.
4
Baylor Scott & White Health-Central Texas, Internal Medicine/Cardiology Division, Temple, Texas.
5
Department of Medical Physiology, Texas A&M University Health Science Center College of Medicine, Temple, Texas.
6
Department of Cell and Molecular Physiology, Health Sciences Division, Loyola University Chicago, Maywood, Illinois; Department of Internal Medicine, Heart, Lung and Vascular Institute, Cardiovascular Center, University of Cincinnati College of Medicine, Cincinnati, Ohio. Electronic address: sadayasl@ucmail.uc.edu.

Abstract

Cardiac myosin binding protein-C (cMyBP-C) is a heart muscle-specific thick filament protein. Elevated level of serum cMyBP-C is an indicator of early myocardial infarction (MI), but its value as a predictor of future cardiovascular disease is unknown. Based on the presence of significant amount of cMyBP-C in the serum of previous study subjects independent of MI, we hypothesized that circulating cMyBP-C is a sensitive indicator of ongoing cardiovascular stress and disease. To test this hypothesis, 75 men and 83 women of similar ages were recruited for a prospective study. They underwent exercise stress echocardiography to provide pre- and poststress blood samples for subsequent determination of serum cMyBP-C levels. The subjects were followed for 1 to 1.5 years. Exercise stress increased serum cMyBP-C in all subjects. Twenty-seven primary events (such as death, MI, revascularization, invasive cardiovascular procedure, or cardiovascular-related hospitalization) and 7 critical events (CE; such as death, MI, stroke, or pulmonary embolism) occurred. After adjusting for sex and cardiovascular risk factors with multivariate Cox regression, a 96% sensitive prestress cMyBP-C threshold carried a hazard ratio of 8.1 with p = 0.041 for primary events. Most subjects (6 of 7) who had CE showed normal ejection fraction on echocardiography. Prestress cMyBP-C demonstrated area under receiver operating curve of 0.91 and multivariate Cox regression hazard ratio of 13.8 (p = 0.000472) for CE. Thus, basal cMyBP-C levels reflected susceptibility for a variety of cardiovascular diseases. Together with its high sensitivity, cMyBP-C holds potential as a screening biomarker for the existence of severe cardiovascular diseases.

PMID:
28847594
PMCID:
PMC6034604
DOI:
10.1016/j.amjcard.2017.07.042
[Indexed for MEDLINE]
Free PMC Article

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