Investigation of Sensitivity and Specificity of Biochemical Markers for Cardiac Contusion due to Blunt Chest Trauma

Objective: There remains a significant need for precise biomarkers to diagnose cardiac contusion. The objective of this study is to examine the diagnostic significance of cardiac myosin-binding protein-C (cMyBP-C) in thoracic injuries, including cardiac contusion. Methods: The inclusion criteria were patients who consented to take part, were over 18 years of age, had sustained severe blunt chest injuries, were admitted within 24 hours post-injury, had their blood samples taken within the first 2 hours of admission, and had at least one of the following injuries: sternal, rib, or left scapular fractures; hemothorax, pneumothorax, pulmonary contusion, traumatic asphyxia, or pneumomediastinum. Troponin I levels ≥ 0.04 ng/mL, measured within 2 hours of admission, are considered the gold standard for diagnosing cardiac contusion. Serum troponin-I concentrations were assessed using an immunochemical technique. Serum cMyBP-C concentrations were measured using an enzyme-linked immunosorbent assay. Results: Participants included 85 patients, with 59 men (69.4%) and a mean age of 48.6 ± 20.8 years (range: 18-84 years). Among them, 18 individuals (21.2%) experienced cardiac contusion. No significant difference was observed in cMyBP-C levels between the cardiac contusion group and the other group (17.7 ± 18.6 vs. 14 ± 15.3, P = 0.328). Receiver operating characteristic analysis revealed that the discriminative performance of cMyBP-C in distinguishing contusion was not statistically significant. In this analysis, the area under the curve for cMyBP-C was 0.575 ± 0.077 (95% confidence interval, 0.425-0.726; P = 0.328), indicating poor discriminative ability and a lack of statistically significant diagnostic value for contusion. Conclusion: While cMyBP-C holds theoretical promise as a cardiomyocyte-specific biomarker, our findings suggest that its current diagnostic performance may be limited in the context of blunt cardiac contusion. Further studies with larger cohorts and refined detection methods are warranted to clarify its clinical utility.