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Cardiac Myosin-Binding Protein C (MyBPC3, cMyC, cardiac MyBP-C)


  •         NEW very early marker of acute myocardial infarction (AMI)
  •         IMPROVEMENT in diagnostic efficacy of hs-cTnT or hs-TnI

Learn more about cardiac MyBP-C assay. Laboratory protocol for cardiac MyBP-C ELISA kit.

Only 32% of patients with an ultimate diagnosis of AMI have diagnostic ECG changes of ST-elevation or depression that facilitate immediate triage [Ref 1,2], the remaining two-thirds of all patients eventually diagnosed with an acute coronary syndrome (ACS) present with non-ST elevation myocardial infarction (NSTEMI) [Ref 3].  The current ECS guideline suggests cardiac troponin (cTn), preferably high-sensitivity or ultrasensitive troponin assays, for laboratory investigations.

The algorithm to rule-in or rule-out AMI in individuals with chest pain longer than 3 hours, according to ECS 2015 guidelines based on laboratory measurements of high sensitivity troponin T (hs-cTnT).


Several publications have recently reported on the variable effectiveness of the ESC algorithm in clinical practice - many patients have to undergo a second blood draw for a more refined triage, and only 20–30% of patients benefit from immediate rule-out/-in using the cut-offs published [Ref 4-7]. MyBPC3 was described as a novel cardiac protein, which is released more rapidly than cardiac troponin [Ref 8-10] at equal, absolute tissue specificity. 

Cardiac myosin-binding protein C (also MyBPC3, cMyC, cardiac MyBPC, cMyBP-C, MyBPC3) is a 140 kDa structural protein composed of 1273 amino acids that belongs to MyBP-C protein family. There are 3 isoforms of MyBP-C known in adult muscle: slow skeletal, fast skeletal and cardiac. The cardiac isoform is present only in the Heart, and it is localized in the inner two-thirds of the A-band in the cardiac sarcomere.

Tissue expression profile of MyBPC3:


Transferred from en.wikipedia. Diagram created by AndrewGNF based on data from Su AI, Wiltshire T, Batalov S, et al (2004). "A gene atlas of the mouse and human protein-encoding transcriptomes". Proc. Natl. Acad. Sci. U.S.A. 101 (16): 6062–7. doi:10.1073/pnas.0400782101. PMID 15075390.

Clinical Perspective of Cardiac MyBP-C

Kaier et al.  Cardiac Myosin-Binding Protein C to Diagnose Acute Myocardial Infarction in the Pre-Hospital Setting. J Am Heart Assoc. 2019 Aug 6;8(15):

  • Discrimination power was significantly better for MyBPC3 than for high-sensitivity cardiac troponin T, and MyBPC3 at the previously published threshold of 10 ng/L for rule-out of AMI reached 100% sensitivity and negative predictive value in patients with only 2 hours of symptoms
  • MyBPC3 could significantly improve the early triage of patients with suspected AMI and represents progress in laboratory diagnostics

Kaier et al. Cardiac Myosin-Binding Protein C-From Bench to Improved Diagnosis of Acute Myocardial Infarction. Cardiovasc Drugs Ther. 2019 Apr;33(2):221-230:

  • MyBPC3  has better triage capability over hs-cTn resulting in a smaller observe-zone
  • Rule-out: 10 ng/L   Rule-in: 120 ng/L for early presenters (chest pain < 3 hours)

Kaier et al.  Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction. Circulation. 2018 Jul 31;138(5):544-545:

  • MyBPC3 has correctly triaged more patients to rule-out and rule-in groups than either high-sensitivity cardiac troponin I or high-sensitivity cardiac troponin T

Other clinical applications

  • cardiomarker of myocardial injury and fibrosis in aortic stenosis [Ref 11]
  • biomarker of hypertrophic cardiomyopathy: a 25-base pair deletion in MyBPC3 gene modifies C10 domain resulting in contractile dysfunction and is associated with hypertrophic cardiomyopathy [Ref 12]


Manufactured by BioVendor

Cat. No. Size Price

RD191470200R 96 wells (1 kit) 595 €


  1. Jennings SM et al. Trends in hospitalization for acute myocardial infarction in Ireland, 1997-2008. Heart. 2012;98(17):1285–1289.
  2. Rogers WJ et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. Am Heart J. 2008;156(6):1026–34.
  3. McManus DD et al. Recent Trends in the Incidence, Treatment, and Outcomes of Patients with STEMI and NSTEMI. Am J Med. 2011;124(1):40–7.
  4. Ambavane A et al. Economic evaluation of the one-hour rule-out and rule-in algorithm for acute myocardial infarction using the high-sensitivity cardiac troponin T assay in the emergency department. PLoS One. 2017;12(11):e0187662.
  5. Andruchow JE et al. Contemporary Emergency Department Management of Patients with Chest Pain: A Concise Review and Guide for the High-Sensitivity Troponin Era. Can J Cardiol. 2018;34(2):98–108.
  6. Boeddinghaus J et al. Direct Comparison of 4 Very Early Rule-Out Strategies for Acute Myocardial Infarction Using High-Sensitivity Cardiac Troponin I. Circulation. 2017;135(17):1597–611.
  7. Alaour B et al. Cardiac Troponin – Diagnostic Problems and Impact on Cardiovascular Disease. Ann Med. 2018:1–32.
  8. Katus HA et al. Diagnostic efficiency of troponin T measurements in acute myocardial infarction. Circulation. 1991;83(3):902–12.
  9. Katus HA et al. Intracellular compartmentation of cardiac troponin T and its release kinetics in patients with reperfused and nonreperfused myocardial infarction. Am J Cardiol. 1991;67(16):1360–7.
  10. Kaier et al. Cardiac Myosin-Binding Protein C-From Bench to Improved Diagnosis of Acute Myocardial Infarction. Cardiovasc Drugs Ther. 2019 Apr;33(2):221-230.
  11. Anand A et al. Cardiac myosin-binding protein C is a novel marker of myocardial injury and fibrosis in aortic stenosis. Heart. 2018 Jul;104(13):1101-1108
  12. Kuster DWD et al. Altered C10 domain in cardiac myosin binding protein-C results in hypertrophic cardiomyopathy. Cardiovasc Res. 2019 Dec 1;115(14):1986-1997.

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