{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:56:34Z","timestamp":1785891394622,"version":"3.56.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1353,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"UiT the Arctic University of North Norway"},{"DOI":"10.13039\/501100007137","name":"Helse Nord RHF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007137","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department of Laboratory Medicine, University Hospital of North Norway"},{"DOI":"10.13039\/501100007137","name":"Helse Nord RHF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007137","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this study was to establish age-specific and sex-specific cut-off values for N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-troponin T) in healthy subjects and assess cardiac biomarkers as screening tools for subclinical heart failure (HF) in a general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Altogether, 1936 participants were randomly selected from the general population Troms\u00f8 7 study in Northern Norway. Diagnostic accuracy (sensitivity, specificity, and negative and positive predictive value) of cardiac markers for echocardiographically defined subclinical HF was evaluated. The receiver-operating characteristic analysis showed that areas under the curve were relatively low (under 0.75) for both NT-proBNP and hs-troponin T, suggesting that the diagnostic accuracy of these biomarkers for subclinical HF was not excellent, especially for mild forms of HF and younger age group 40\u201349 years. Sex-specific and age-specific cut-offs for hs-troponin T (99th percentiles) and NT-proBNP (97.5th percentiles) were established in healthy subjects from the same general population. The sex-specific and age-specific cut-offs for NT-proBNP had higher specificity for subclinical HF compared with the previously established single cut-off 125 pg\/mL. Age-specific cut-off for hs-troponin T (18 ng\/L) for men \u226560 years had also higher specificity than the single cut-off 14 ng\/L. These cut-offs had high specificity, but low sensitivity, that makes hs-troponin T and NT-proBNP good biomarkers to rule in HF in case of a positive test, but not good enough to rule out all unrecognized HF due to false negative results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>N-terminal pro-brain natriuretic peptide and hs-troponin T are suboptimal screening tools for subclinical HF in a general population due to low sensitivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13906","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T21:04:23Z","timestamp":1648069463000},"page":"1954-1962","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["NT-ProBNP and High-Sensitivity Troponin T as Screening Tests for Subclinical Chronic Heart Failure in a General Population"],"prefix":"10.1093","volume":"9","author":[{"given":"Maria","family":"Averina","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, University Hospital of North Norway , Troms\u00f8, 9038 ,","place":["Norway"]},{"name":"Department of Community Medicine, UiT the Arctic University of Norway , Troms\u00f8 ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stylidis","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, UiT the Arctic University of Norway , Troms\u00f8 ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Brox","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University Hospital of North Norway , Troms\u00f8, 9038 ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Schirmer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital , L\u00f8renskog ,","place":["Norway"]},{"name":"Institute of Clinical Medicine, Cardiovascular Research Group, Campus Ahus, University of Oslo , Oslo ,","place":["Norway"]},{"name":"Institute of Clinical Medicine, UiT the Arctic University of Norway , Troms\u00f8 ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"2026012114234395900_ehf213906-bib-0001","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"},{"key":"2026012114234395900_ehf213906-bib-0002","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1056\/NEJMoa052256","article-title":"Trends in prevalence and outcome of heart failure with preserved ejection fraction","volume":"355","author":"Owan","year":"2006","journal-title":"N Engl J Med"},{"key":"2026012114234395900_ehf213906-bib-0003","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1001\/jamainternmed.2013.8412","article-title":"Echocardiographic screening of the general population and long-term survival: a randomized clinical study","volume":"173","author":"Lindekleiv","year":"2013","journal-title":"JAMA Intern Med"},{"key":"2026012114234395900_ehf213906-bib-0004","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1001\/jama.289.2.194","article-title":"Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic","volume":"289","author":"Redfield","year":"2003","journal-title":"JAMA"},{"key":"2026012114234395900_ehf213906-bib-0005","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1136\/hrt.2003.025270","article-title":"Clinical epidemiology of heart failure","volume":"93","author":"Mosterd","year":"2007","journal-title":"Heart"},{"key":"2026012114234395900_ehf213906-bib-0006","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.cardfail.2015.06.007","article-title":"Subclinical abnormalities in echocardiographic parameters and risk of sudden cardiac death in a general population: the Rotterdam study","volume":"22","author":"Niemeijer","year":"2016","journal-title":"J Card Fail"},{"key":"2026012114234395900_ehf213906-bib-0007","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1001\/archinternmed.2011.244","article-title":"Mortality rate in patients with diastolic dysfunction and normal systolic function","volume":"171","author":"Halley","year":"2011","journal-title":"Arch Intern Med"},{"key":"2026012114234395900_ehf213906-bib-0008","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1002\/ejhf.663","article-title":"Biomarker-based risk prediction in the community","volume":"18","author":"AbouEzzeddine","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026012114234395900_ehf213906-bib-0009","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1093\/eurheartj\/ehs104","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC","volume":"33","author":"McMurray","year":"2012","journal-title":"Eur Heart J"},{"key":"2026012114234395900_ehf213906-bib-0010","article-title":"Diagnostic accuracy of natriuretic peptides for heart failure in patients with pleural effusion: a systematic review and updated meta-analysis","volume":"10","author":"Han","year":"2015","journal-title":"PLoS ONE"},{"key":"2026012114234395900_ehf213906-bib-0011","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.ijcard.2008.11.107","article-title":"Direct comparison of B-type natriuretic peptide and N-terminal pro-BNP for assessment of cardiac function in a large population of symptomatic patients","volume":"140","author":"Park","year":"2010","journal-title":"Int J Cardiol"},{"key":"2026012114234395900_ehf213906-bib-0012","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.cardfail.2008.12.002","article-title":"The role of N-terminal PRO-brain natriuretic peptide and echocardiography for screening asymptomatic left ventricular dysfunction in a population at high risk for heart failure. The PROBE-HF study","volume":"15","author":"Betti","year":"2009","journal-title":"Cardiac Fail"},{"key":"2026012114234395900_ehf213906-bib-0013","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1093\/eurjhf\/hft098","article-title":"Evaluation of different strategies for identifying asymptomatic left ventricular dysfunction and pre-clinical (stage B) heart failure in the elderly. Results from \u2018PREDICTOR\u2019, a population based-study in central Italy","volume":"15","author":"Mureddu","year":"2013","journal-title":"Eur J Heart Fail"},{"key":"2026012114234395900_ehf213906-bib-0014","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1056\/NEJMoa031994","article-title":"Plasma natriuretic peptide levels and the risk of cardiovascular events and death","volume":"350","author":"Wang","year":"2004","journal-title":"N Engl J Med"},{"key":"2026012114234395900_ehf213906-bib-0015","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.archger.2015.05.001","article-title":"Clinical value of NT-proBNP assay in the emergency department for the diagnosis of heart failure (HF) in very elderly people","volume":"61","author":"Bombelli","year":"2015","journal-title":"Arch Gerontol Geriatr"},{"key":"2026012114234395900_ehf213906-bib-0016","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.amjmed.2014.09.029","article-title":"Prognostic comparison of different sensitivity cardiac troponin assays in stable heart failure","volume":"128","author":"Grodin","year":"2015","journal-title":"Am J Med"},{"key":"2026012114234395900_ehf213906-bib-0017","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1016\/j.ijcard.2012.04.063","article-title":"Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay","volume":"167","author":"Keller","year":"2013","journal-title":"Int J Cardiol"},{"key":"2026012114234395900_ehf213906-bib-0018","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.ijcard.2016.01.213","article-title":"Diagnostic and prognostic implications using age-and gender-specific cut-offs for high-sensitivity cardiac troponin T\u2014sub-analysis from the TRAPID-AMI study","volume":"209","author":"Mueller-Hennessen","year":"2016","journal-title":"Int J Cardiol"},{"key":"2026012114234395900_ehf213906-bib-0019","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.archger.2016.03.010","article-title":"High-sensitivity cardiac troponin T in geriatric inpatients","volume":"65","author":"Zhang","year":"2016","journal-title":"Arch Gerontol Geriatr"},{"key":"2026012114234395900_ehf213906-bib-0020","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1161\/CIRCHEARTFAILURE.112.968545","article-title":"Estimating glomerular filtration rate using the chronic kidney disease-epidemiology collaboration creatinine equation: better risk predictions","volume":"5","author":"Inker","year":"2012","journal-title":"Circ Heart Fail"},{"key":"2026012114234395900_ehf213906-bib-0021","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.cca.2010.12.034","article-title":"Multicenter analytical evaluation of a high-sensitivity troponin T assay","volume":"412","author":"Saenger","year":"2011","journal-title":"Clin Chim Acta"},{"key":"2026012114234395900_ehf213906-bib-0022","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.echo.2018.09.011","article-title":"Classification of left ventricular diastolic dysfunction and heart failure diagnosis and prognosis","volume":"31","author":"Nagueh","year":"2018","journal-title":"J Am Soc Echocardiogr"},{"key":"2026012114234395900_ehf213906-bib-0023","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1373\/clinchem.2019.306621","article-title":"Educational recommendations on selected analytical and clinical aspects of natriuretic peptides with a focus on heart failure: a report from the IFCC committee on clinical applications of cardiac bio-markers","volume":"65","author":"Kavsak","year":"2019","journal-title":"Clin Chem"},{"key":"2026012114234395900_ehf213906-bib-0024","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1373\/clinchem.2015.246280","article-title":"STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies","volume":"61","author":"Bossuyt","year":"2015","journal-title":"Clin Chem"},{"key":"2026012114234395900_ehf213906-bib-0025","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1373\/clinchem.2009.132654","article-title":"Analytical validation of a high-sensitivity cardiac troponin T assay","volume":"56","author":"Giannitsis","year":"2010","journal-title":"Clin Chem"},{"key":"2026012114234395900_ehf213906-bib-0026","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1515\/cclm-2012-0541","article-title":"Midregional pro-atrial natriuretic peptide in the general population\/insights from the Gutenberg Health Study","volume":"51","author":"Tzikas","year":"2013","journal-title":"Clin Chem Lab Med"},{"key":"2026012114234395900_ehf213906-bib-0027","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1016\/j.cardfail.2005.04.022","article-title":"Diagnostic and prognostic performance of N-terminal ProBNP in primary care patients with suspected heart failure","volume":"11","author":"Gustafsson","year":"2005","journal-title":"J Card Fail"},{"key":"2026012114234395900_ehf213906-bib-0028","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.recesp.2012.01.019","article-title":"Rapid point-of-care NT-proBNP optimal cut-off point for heart failure diagnosis in primary care","volume":"65","author":"Verd\u00fa","year":"2012","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2026012114234395900_ehf213906-bib-0029","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.ejheart.2005.01.022","article-title":"The diagnostic accuracy of plasma BNP and NTproBNP in patients referred from primary care with suspected heart failure: results of the UK natriuretic peptide study","volume":"7","author":"Zaphiriou","year":"2005","journal-title":"Eur J Heart Fail"},{"key":"2026012114234395900_ehf213906-bib-0030","first-page":"327","article-title":"The diagnostic accuracy and utility of a B-type natriuretic peptide test in a community population of patients with suspected heart failure","volume":"56","author":"Fuat","year":"2006","journal-title":"Br J Gen Pract"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13906","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13906","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/3\/1954\/65668922\/eschf_9_3_1954.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/3\/1954\/65668922\/eschf_9_3_1954.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:29:43Z","timestamp":1769023783000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/9\/3\/1954\/8362445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,23]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,23]]},"published-print":{"date-parts":[[2022,6,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13906","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,6]]},"published":{"date-parts":[[2022,3,23]]},"assertion":[{"value":"2021-10-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}