The latest ESC guideline, published 29th of August 2020, was one of the highlights of the ESC online Congress 2020.
Some significant changes regarding the use biomarkers are to be noted, including that cardiac Myosin-binding protein C (cMyC) is now part of the guideline.
Here is a key excerpt (Section 18.104.22.168):
“Among the multitude of additional biomarkers evaluated for the diagnosis of NSTE-ACS, only CK-MB, myosin-binding protein C, and copeptinmay have clinical relevance in specific clinical settings when used in combination with cardiac troponin T/I. Compared with cardiac troponin, CK-MB shows a more rapid decline after MI and may provide added value for the timing of myocardial injury and the detection of early reinfarction. However, it is important to highlight that little is known on how to best diagnose early reinfarction.
Detailed clinical assessment including chest pain characteristics (same characteristics as index event), 12-lead ECG for the detection of new ST-segment changes or T-wave inversion, as well as serial measurement of cardiac troponin T/I and CK/CK-MB is recommended. Myosin-binding protein C is more abundant than cardiac troponin and may therefore, provide value as an alternative to, or in combination with, cardiac troponin.”
You can find the complete European Society of Cardiology (ESC) guidelines for NSTEMI at: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaa575/5898842
This confirms overall acceptance of cMyC and will facilitate worldwide adoption and accelerate reimbursement approvals.
Please take care and stay healthy.
Your Expand Healthcare Consulting Team