Dalam beberapa tahun terakhir, cardiac myosin-binding protein C (cMyC) telah diteliti sebagai marker untuk mendeteksi infark miokard akut (IMA). Pemeriksaan cardiac myosin-binding protein C diharapkan dapat mengatasi kelemahan marker IMA saat ini.
Troponin T dan I merupakan marker yang sering digunakan untuk mendiagnosis infark miokard akut karena sensitivitas dan spesifisitasnya lebih tinggi daripada marker lain, seperti creatine kinase–MB dan mioglobin. Sayangnya, troponin ini baru terdeteksi 4–6 jam setelah onset gejala. Selain itu, troponin dapat terdeteksi hingga 14 hari, sehingga tidak ideal untuk mendiagnosis infark ulang yang dapat terjadi dalam 28 hari.[1,2]
Untuk memasukkan dan menyingkirkan (rule–in dan rule–out) diagnosis IMA di triase, European Society of Cardiology menyarankan pemeriksaan high–sensitivity cardiac troponin T dan I (hsTnT dan hsTnI). Marker ini dapat terdeteksi 1–3 jam setelah onset gejala. Namun, pemeriksaan hsTnT dan hsTnI yang <3 jam sering memberikan hasil “abu–abu”, sehingga diperlukan pemeriksaan ulang 3 jam setelah onset gejala.[3]
(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)
Referensi
1. Schreiber D. Cardiac markers. Medscape. 2018.
2. Baker JO, Tyther R, Liebetrau C, et al. Cardiac myosin-binding protein C: a potential early biomarker of myocardial injury. Basic Res Cardiol. 2015;110(3):23. doi:10.1007/s00395-015-0478-5
3. Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2020 Aug 29:ehaa575. doi: 10.1093/eurheartj/ehaa575
4. Kaier TE, Twerenbold R, Puelacher C, et al. Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction. Circulation. 2017 Oct 17;136(16):1495-1508. doi: 10.1161/CIRCULATIONAHA.117.028084
5. Flashman E, Redwood C, Moolman-Smook J, Watkins H. Cardiac myosin binding protein C: its role in physiology and disease. Circ Res. 2004 May 28;94(10):1279-89. doi: 10.1161/01.RES.0000127175.21818.C2
6. Lynch TL, Sadayappan S. Surviving the infarct: A profile of cardiac myosin binding protein-C pathogenicity, diagnostic utility, and proteomics in the ischemic myocardium. Proteomics Clin Appl. 2014 Aug;8(7-8):569-77. doi: 10.1002/prca.201400011
7. Kuster DW, Cardenas-Ospina A, Miller L, et al. Release kinetics of circulating cardiac myosin binding protein-C following cardiac injury. Am J Physiol Heart Circ Physiol. 2014 Feb 15;306(4):H547-56. doi: 10.1152/ajpheart.00846.2013
8. Govindan S, Kuster DW, Lin B, et al. Increase in cardiac myosin binding protein-C plasma levels is a sensitive and cardiac-specific biomarker of myocardial infarction. Am J Cardiovasc Dis. 2013;3(2):60-70.
9. Anand A, Chin C, Shah A, et al. 151 Cardiac Myosin-Binding Protein C is a Novel Marker of Myocardial Injury and Fibrosis in Patients with Aortic Stenosis. Heart. 2016;102:A109-A110. http://heart.bmj.com/content/102/Suppl_6/A109.2
10. Schulte C et al. Serial measurements of protein and microRNA biomarkers to specify myocardial infarction subtypes. J Mol Cell Cardiol Plus. 2022. 10.1016/j.jmccpl.2022.100014. https://pmc.ncbi.nlm.nih.gov/articles/PMC9514835/
11. Kaier TE, Alaour B, Marber M. Cardiac Myosin-Binding Protein C-From Bench to Improved Diagnosis of Acute Myocardial Infarction. Cardiovasc Drugs Ther. 2019;33(2):221-230. doi:10.1007/s10557-018-6845-3
12. Tong CW, Dusio GF, Govindan S, et al. Usefulness of Released Cardiac Myosin Binding Protein-C as a Predictor of Cardiovascular Events. Am J Cardiol. 2017 Nov 1;120(9):1501-1507. doi: 10.1016/j.amjcard.2017.07.042
Facebook 
Masuk dengan Email
