{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T16:07:04Z","timestamp":1784045224097,"version":"3.55.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014091","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014091","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016545","name":"Roche Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Myocardial injury is a hallmark of heart failure (HF). It is unknown whether established (e.g. troponin) or novel biomarkers of myocardial injury [e.g. cardiac myosin-binding protein C (cMyBP-C)] provide additive diagnostic value beyond natriuretic peptides in community patients with suspected HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Community-based patients with suspected HF and elevated NT-proBNP levels were recruited into a multicentre, prospective, observational study at five sites (NCT04724200). Venous blood sampling was performed at the time of echocardiography. HF was classified according to left ventricular ejection fraction: HF with reduced ejection fraction (HFrEF) = \u226440%, HF with mildly reduced ejection (HFmrEF) = 41\u201349%, and HF with preserved ejection fraction (HFpEF) = \u226550% with HFA-PEFF score \u22655. NT-proBNP (Roche Elecsys\u00ae assay), high-sensitivity cardiac troponin T (hs-cTnT, Roche Elecsys\u00ae assay) and cMyBP-C (Roche precommercial assay) were measured. Diagnostic accuracy of each biomarker alone and in combination was examined using the area under the receiver operating characteristic curve (AUROC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 867 patients, 751 (87%) had measurable left ventricular ejection fraction and available biomarker data. Of these, 43 (6%) had HFrEF, 75 (10%) HFmrEF, and 278 (37%) HFpEF. NT-proBNP levels were highest in patients with HFrEF, with similar patterns observed for hsTnT and cMyBP-C. For the diagnosis of HF versus no HF, the combination of NT-proBNP and cMyBP-C had the highest AUROC of 0.77 (95%CI 0.73\u20130.80) versus NT-proBNP alone [0.74 (0.71\u20130.78); P = .003]. For detection of HFrEF versus no HF, the AUROC was 0.90 (0.86\u20130.95) for the combination of NT-proBNP and cMyBP-C compared with 0.85 (0.80\u20130.90) for NT-proBNP alone (P = .006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Measurement of cMyBP-C improved the diagnostic accuracy of NT-proBNP in community-based patients with suspected HF, with greatest additive value for identifying HFrEF, and may help in the prioritization of echocardiography.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag143","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:55:50Z","timestamp":1783684550000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiac myosin-binding protein C in community-based patients with suspected heart failure"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5446-9969","authenticated-orcid":false,"given":"Kieran F","family":"Docherty","sequence":"first","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4517-272X","authenticated-orcid":false,"given":"Mark C","family":"Petrie","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"McKinley","sequence":"additional","affiliation":[{"name":"Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Bear","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katriona J M","family":"Brooksbank","sequence":"additional","affiliation":[{"name":"West of Scotland Innovation Hub, NHS Greater Glasgow and Clyde , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Lowe","sequence":"additional","affiliation":[{"name":"West of Scotland Innovation Hub, NHS Greater Glasgow and Clyde , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leeanne","family":"Macklin","sequence":"additional","affiliation":[{"name":"Forth Valley Royal Hospital , Larbert ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee","family":"McCoubrey","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8419-0838","authenticated-orcid":false,"given":"Joanna","family":"Osmanska","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Taylor Sweet","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binder","family":"Fagura","sequence":"additional","affiliation":[{"name":"AstraZeneca , Cambridge ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2809-0266","authenticated-orcid":false,"given":"Tatjana","family":"Ammer","sequence":"additional","affiliation":[{"name":"Roche Diagnostics GmbH , Penzberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Palme","sequence":"additional","affiliation":[{"name":"Roche Diagnostics GmbH , Penzberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Masson","sequence":"additional","affiliation":[{"name":"Roche Diagnostics International Ltd , Rotkreuz ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7262-7000","authenticated-orcid":false,"given":"Alex","family":"McConnachie","sequence":"additional","affiliation":[{"name":"Robertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7970-3643","authenticated-orcid":false,"given":"Paul","family":"Welsh","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J V","family":"McMurray","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0050-2129","authenticated-orcid":false,"given":"Ross T","family":"Campbell","sequence":"additional","affiliation":[{"name":"BHF Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow, Scotland G12 8TA ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"2026071411340249100_xuag143-B1","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1001\/jamacardio.2019.3113","article-title":"Association between circulating troponin concentrations, left ventricular systolic and diastolic functions, and incident heart failure in older adults","volume":"4","author":"Myhre","year":"2019","journal-title":"JAMA Cardiol"},{"key":"2026071411340249100_xuag143-B2","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1161\/CIRCULATIONAHA.110.005264","article-title":"Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the Atherosclerosis Risk in Communities Study","volume":"123","author":"Saunders","year":"2011","journal-title":"Circulation"},{"key":"2026071411340249100_xuag143-B3","doi-asserted-by":"publisher","first-page":"2538","DOI":"10.1056\/NEJMoa0805299","article-title":"A sensitive cardiac troponin T assay in stable coronary artery disease","volume":"361","author":"Omland","year":"2009","journal-title":"N Engl J Med"},{"key":"2026071411340249100_xuag143-B4","doi-asserted-by":"publisher","first-page":"2265","DOI":"10.1093\/eurheartj\/ehs191","article-title":"Troponin elevation in patients with heart failure: on behalf of the third Universal Definition of Myocardial Infarction Global Task Force: Heart Failure Section","volume":"33","author":"Januzzi","year":"2012","journal-title":"Eur Heart J"},{"key":"2026071411340249100_xuag143-B5","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.2337\/dci22-0014","article-title":"Heart failure: an underappreciated complication of diabetes. A consensus report of the American Diabetes Association","volume":"45","author":"Pop-Busui","year":"2022","journal-title":"Diabetes Care"},{"key":"2026071411340249100_xuag143-B6","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1016\/j.jacc.2021.12.011","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"79","author":"Heidenreich","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026071411340249100_xuag143-B7","doi-asserted-by":"publisher","first-page":"1891","DOI":"10.1002\/ejhf.3036","article-title":"Practical algorithms for early diagnosis of heart failure and heart stress using NT-proBNP: a clinical consensus statement from the Heart Failure Association of the ESC","volume":"25","author":"Bayes-Genis","year":"2023","journal-title":"Eur J Heart Fail"},{"key":"2026071411340249100_xuag143-B8","doi-asserted-by":"publisher","first-page":"S207","DOI":"10.2337\/dc25-S010","article-title":"10. Cardiovascular disease and risk management: standards of care in diabetes-2025","volume":"48","author":"American Diabetes Association Professional Practice Committee","year":"2025","journal-title":"Diabetes Care"},{"key":"2026071411340249100_xuag143-B9","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s00395-015-0478-5","article-title":"Cardiac myosin-binding protein C: a potential early biomarker of myocardial injury","volume":"110","author":"Baker","year":"2015","journal-title":"Basic Res Cardiol"},{"key":"2026071411340249100_xuag143-B10","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1161\/CIRCULATIONAHA.117.028084","article-title":"Direct comparison of cardiac myosin-binding protein C with cardiac troponins for the early diagnosis of acute myocardial infarction","volume":"136","author":"Kaier","year":"2017","journal-title":"Circulation"},{"key":"2026071411340249100_xuag143-B11","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1093\/ehjacc\/zuac007","article-title":"A 0\/1h-algorithm using cardiac myosin-binding protein C for early diagnosis of myocardial infarction","volume":"11","author":"Kaier","year":"2022","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"2026071411340249100_xuag143-B12","doi-asserted-by":"publisher","first-page":"2616","DOI":"10.1016\/j.jacc.2025.09.008","article-title":"Incremental value of cardiac myosin-binding protein C for the early diagnosis of acute myocardial infarction","volume":"86","author":"Lopez-Ayala","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"2026071411340249100_xuag143-B13","doi-asserted-by":"publisher","first-page":"1917","DOI":"10.1039\/C004495D","article-title":"Proteome-wide protein concentrations in the human heart","volume":"6","author":"Aye","year":"2010","journal-title":"Mol Biosyst"},{"key":"2026071411340249100_xuag143-B14","doi-asserted-by":"publisher","first-page":"3401","DOI":"10.1002\/ejhf.3783","article-title":"Artificial intelligence fully automated analysis of handheld echocardiography in real-world patients with suspected heart failure","volume":"27","author":"Campbell","year":"2025","journal-title":"Eur J Heart Fail"},{"key":"2026071411340249100_xuag143-B15","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1093\/ehjci\/jex244","article-title":"Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging","volume":"18","author":"Galderisi","year":"2017","journal-title":"Eur Heart J\u2014Cardiovasc Imaging"},{"key":"2026071411340249100_xuag143-B16","doi-asserted-by":"crossref","unstructured":"Robinson S, Rana B, Oxborough D, Steeds R, Monaghan M, Stout M, et al \u00a0A practical guideline for performing a comprehensive transthoracic echocardiogram in adults: the British Society of Echocardiography minimum dataset. Echo Res Pract \u00a02020;7:G59\u201393. 10.1530\/ERP-20-0026","DOI":"10.1530\/ERP-20-0026"},{"key":"2026071411340249100_xuag143-B17","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2026071411340249100_xuag143-B18","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1002\/ejhf.1741","article-title":"How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)","volume":"22","author":"Pieske","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"2026071411340249100_xuag143-B19","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1016\/j.yjmcc.2009.11.014","article-title":"Phosphorylation and function of cardiac myosin binding protein-C in health and disease","volume":"48","author":"Barefield","year":"2010","journal-title":"J Mol Cell Cardiol"},{"key":"2026071411340249100_xuag143-B20","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1161\/CIRCRESAHA.113.301225","article-title":"An endogenously produced fragment of cardiac myosin binding protein C is pathogenic and can lead to heart failure","volume":"113","author":"Razzaque","year":"2013","journal-title":"Circ Res"},{"key":"2026071411340249100_xuag143-B21","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1093\/clinchem\/hvaf013","article-title":"Determinants of cardiac myosin binding protein C in the general population","volume":"71","author":"Paus","year":"2025","journal-title":"Clin Chem"},{"key":"2026071411340249100_xuag143-B22","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1136\/heartjnl-2017-312257","article-title":"Cardiac myosin-binding protein C is a novel marker of myocardial injury and fibrosis in aortic stenosis","volume":"104","author":"Anand","year":"2018","journal-title":"Heart Br Card Soc"},{"key":"2026071411340249100_xuag143-B23","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1002\/ejhf.2094","article-title":"Investigators for the BV. Cardiac myosin-binding protein C in the diagnosis and risk stratification of acute heart failure","volume":"23","author":"Kozhuharov","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2026071411340249100_xuag143-B24","author":"National Institute for Health and Care Excellence","year":"2022"},{"key":"2026071411340249100_xuag143-B25","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1093\/eurheartj\/ehaf675","article-title":"Benefit of early initiation of disease-modifying therapy in community-based patients with suspected heart failure","volume":"47","author":"Docherty","year":"2025","journal-title":"Eur Heart J"},{"key":"2026071411340249100_xuag143-B26","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1161\/CIRCULATIONAHA.121.057852","article-title":"Serial assessment of high-sensitivity cardiac troponin and the effect of dapagliflozin in patients with heart failure with reduced ejection fraction: an analysis of the DAPA-HF trial","volume":"145","author":"Berg","year":"2022","journal-title":"Circulation"},{"key":"2026071411340249100_xuag143-B27","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1016\/j.jchf.2021.04.009","article-title":"Integrating high-sensitivity troponin T and sacubitril\/valsartan treatment in HFpEF: the PARAGON-HF trial","volume":"9","author":"Gori","year":"2021","journal-title":"JACC Heart Fail"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjhf\/advance-article-pdf\/doi\/10.1093\/ejhf\/xuag143\/68771629\/xuag143.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/advance-article-pdf\/doi\/10.1093\/ejhf\/xuag143\/68771629\/xuag143.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:34:10Z","timestamp":1784043250000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjhf\/advance-article\/doi\/10.1093\/ejhf\/xuag143\/8734008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":27,"URL":"https:\/\/doi.org\/10.1093\/ejhf\/xuag143","relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"article-number":"xuag143"}}