{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:35:07Z","timestamp":1791671707724,"version":"4.3.4"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,8,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Early triage is essential to improve outcomes in patients with suspected acute myocardial infarction (\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              ). This study investigated whether cMyC (cardiac myosin\u2010binding protein), a novel biomarker of myocardial necrosis, can aid early diagnosis of\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              and risk stratification.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">cMyC<\/jats:styled-content>\n              and high\u2010sensitivity cardiac troponin T were retrospectively quantified in blood samples obtained by ambulance\u2010based paramedics in a prospective, diagnostic cohort study. Patients with ongoing or prolonged periods of chest discomfort, acute dyspnoea in the absence of known pulmonary disease, or clinical suspicion of\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              were recruited. Discrimination power was evaluated by calculating the area under the receiver operating characteristics curve; diagnostic performance was assessed at predefined thresholds. Diagnostic nomograms were derived and validated using bootstrap resampling in logistic regression models. Seven hundred seventy\u2010six patients with median age 68 [58;78] were recruited.\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              was the final adjudicated diagnosis in 22%. Median symptom to sampling time was 70\u00a0minutes.\n              <jats:styled-content style=\"fixed-case\">cMyC<\/jats:styled-content>\n              concentration in patients with\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              was significantly higher than with other diagnoses: 98 [43;855] versus 17 [9;42] ng\/L. Discrimination power for\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              was better with\n              <jats:styled-content style=\"fixed-case\">cMyC<\/jats:styled-content>\n              than with high\u2010sensitivity cardiac troponin T (area under the curve, 0.839 versus 0.813;\n              <jats:italic>P<\/jats:italic>\n              =0.005). At a previously published rule\u2010out threshold (10\u00a0ng\/L),\n              <jats:styled-content style=\"fixed-case\">cMyC<\/jats:styled-content>\n              reaches 100% sensitivity and negative predictive value in patients after 2\u00a0hours of symptoms. In logistic regression analysis,\n              <jats:styled-content style=\"fixed-case\">cMyC<\/jats:styled-content>\n              is superior to high\u2010sensitivity cardiac troponin T and was used to derive diagnostic and prognostic nomograms to evaluate risk of AMI and death.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In patients undergoing blood draws very early after symptom onset,\n              <jats:styled-content style=\"fixed-case\">cMyC<\/jats:styled-content>\n              demonstrates improved diagnostic discrimination of\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              and could significantly improve the early triage of patients with suspected AMI.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.013152","type":"journal-article","created":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T09:04:05Z","timestamp":1564131845000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Cardiac Myosin\u2010Binding Protein C to Diagnose Acute Myocardial Infarction in the Pre\u2010Hospital Setting"],"prefix":"10.1161","volume":"8","author":[{"given":"Thomas E.","family":"Kaier","sequence":"first","affiliation":[{"name":"King's College London BHF Centre The Rayne Institute St Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Stengaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Marjot","sequence":"additional","affiliation":[{"name":"King's College London BHF Centre The Rayne Institute St Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob Thorsted","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashir","family":"Alaour","sequence":"additional","affiliation":[{"name":"King's College London BHF Centre The Rayne Institute St Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavroula","family":"Stavropoulou\u2010Tatla","sequence":"additional","affiliation":[{"name":"King's College London BHF Centre The Rayne Institute St Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Juhl","family":"Terkelsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Williams","sequence":"additional","affiliation":[{"name":"King's College London BHF Centre The Rayne Institute St Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Thygesen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekkehard","family":"Weber","sequence":"additional","affiliation":[{"name":"Institute of Physiological Chemistry Martin Luther University Halle\u2010Wittenberg Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Marber","sequence":"additional","affiliation":[{"name":"King's College London BHF Centre The Rayne Institute St Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Erik","family":"B\u00f8tker","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv320"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31826e1058"},{"key":"e_1_3_2_4_2","first-page":"e139","article-title":"2014 AHA\/ACC Guideline for the management of patients with non\u2013ST\u2010elevation acute coronary syndromes","volume":"130","author":"Amsterdam EA","year":"2014","unstructured":"Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, Jaffe AS, Jneid H, Kelly RF, Kontos MC, Levine GN, Liebson PR, Mukherjee D, Peterson ED, Sabatine MS, Smalling RW, Zieman SJ. 2014 AHA\/ACC Guideline for the management of patients with non\u2013ST\u2010elevation acute coronary syndromes. Circulation. 2014;130:e139\u2013e228.","journal-title":"Circulation"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.111.962787"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2010.07.023"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.11.032"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872616648468"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs154"},{"key":"e_1_3_2_10_2","first-page":"1","article-title":"The potential of optimizing prehospital triage of patients with suspected acute myocardial infarction using high\u2010sensitivity cardiac troponin T and copeptin","volume":"37","author":"Stengaard C","year":"2016","unstructured":"Stengaard C, S\u00f8rensen JT, Ladefoged SA, Lassen JF, Rasmussen MB, Pedersen CK, Ayer A, B\u00f8tker HE, Terkelsen CJ, Thygesen K. The potential of optimizing prehospital triage of patients with suspected acute myocardial infarction using high\u2010sensitivity cardiac troponin T and copeptin. Biomarkers. 2016;37:1\u201313.","journal-title":"Biomarkers"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2016.264648"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00395-015-0478-5"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2016.257188"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028084"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.032597"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.035880"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.06.026"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2015.11.008"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2009.132654"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.197020"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.194985"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2010.12.034"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm355"},{"key":"e_1_3_2_24_2","first-page":"37","article-title":"Multicentre analytical evaluation of a new point\u2010of\u2010care system for the determination of cardiac and thromboembolic markers","volume":"56","author":"Bertsch T","year":"2010","unstructured":"Bertsch T, Chapelle JP, Dempfle CE, Giannitsis E, Schwabs M, Zerback R. Multicentre analytical evaluation of a new point\u2010of\u2010care system for the determination of cardiac and thromboembolic markers. Clin Lab. 2010;56:37\u201349.","journal-title":"Clin Lab"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4085"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022677"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.06.049"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38985.646481.55"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.3368"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.013152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:55:19Z","timestamp":1715601319000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.013152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,6]]},"references-count":29,"journal-issue":{"issue":"15","published-print":{"date-parts":[[2019,8,6]]}},"alternative-id":["10.1161\/JAHA.119.013152"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.013152","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,6]]},"assertion":[{"value":"2019-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e013152"}}