{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T00:12:03Z","timestamp":1793664723989,"version":"4.5.1"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"\n Importance<\/jats:title>\n High-sensitivity cardiac troponin T and I assays are considered equivalent for the diagnosis of myocardial infarction. However, the impact of transitioning from an assay measuring cardiac troponin I to one measuring cardiac troponin T on patient care and clinical outcomes is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the impact of transitioning from a high-sensitivity assay measuring cardiac troponin I to one measuring cardiac troponin T on the care and outcomes of consecutive patients with suspected acute coronary syndrome.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This was a prospective, multicenter, interrupted time-series study conducted at 3 acute care centers. Consecutive patients presenting with suspected acute coronary syndrome to an acute care hospital were identified between October 2020 and October 2022.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n All sites changed from an assay measuring cardiac troponin I to one measuring cardiac troponin T in October 2021.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was hospital admission.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 25\u202f849 patients, 13\u202f146 (median [IQR] age, 60 [47-73] years; 6961 male [53%]) and 12\u202f703 (median [IQR] age, 60 [47-73] years; 6825 male [54%]) presented before and after the transition to cardiac troponin T, respectively. The proportion of patients with myocardial injury increased from 21% (2800 of 13\u202f146 patients) to 38% (4781 of 12\u202f703 patients), and patients were more likely to be admitted to the hospital after the transition (odds ratio [OR], 2.24; 95% CI, 1.81-2.77; both\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). A 6-fold increase in serial testing was observed in patients undergoing a measure of cardiac troponin T compared with cardiac troponin I (OR, 6.03; 95% CI, 4.85-7.49;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Subsequent myocardial infarction, heart failure, or cardiovascular death at 1 year was comparable before and after the transition (OR, 0.83; 95% CI, 0.48-1.41;\n P<\/jats:italic>\n \u2009=\u2009.49).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The transition from a high-sensitivity assay measuring cardiac troponin I to one measuring cardiac troponin T was associated with increased identification of myocardial injury, serial troponin measurements, and hospital admissions without evidence of improved cardiovascular outcomes at 1 year.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT05748691<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamacardio.2025.4661","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T16:00:24Z","timestamp":1765987224000},"page":"186","source":"Crossref","is-referenced-by-count":6,"title":["Clinical Decisions and Outcomes After Switching High-Sensitivity Cardiac Troponin Assays in Suspected ACS"],"prefix":"10.1001","volume":"11","author":[{"given":"Jasper","family":"Boeddinghaus","sequence":"first","affiliation":[{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom"},{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziwen","family":"Li","sequence":"additional","affiliation":[{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anda","family":"Bularga","sequence":"additional","affiliation":[{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caelan","family":"Taggart","sequence":"additional","affiliation":[{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Wereski","sequence":"additional","affiliation":[{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Chapman","sequence":"additional","affiliation":[{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan Ken","family":"Lee","sequence":"additional","affiliation":[{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Tuck","sequence":"additional","affiliation":[{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Gunn","sequence":"additional","affiliation":[{"name":"Department Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Jenks","sequence":"additional","affiliation":[{"name":"Department Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty","family":"McCance","sequence":"additional","affiliation":[{"name":"Department Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Pattenden","sequence":"additional","affiliation":[{"name":"Department Clinical Biochemistry, Western General Hospital, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Malo","sequence":"additional","affiliation":[{"name":"Department Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J. 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