{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:49:23Z","timestamp":1792410563703,"version":"4.4.0"},"reference-count":27,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019901","name":"Stiftung Lindenhof Bern","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019901","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008578","name":"Jubil\u00e4umsstiftung der Schweizerischen Lebensversicherungs- und Rentenanstalt f\u00fcr Volksgesundheit und medizinische Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008578","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004784","name":"Novartis Stiftung f\u00fcr Medizinisch-Biologische Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004784","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100032886","name":"Theodor und Ida Herzog-Egli-Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100032886","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007348","name":"Schweizerische Gesellschaft f\u00fcr Radiologie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004362","name":"Schweizerische Herzstiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004362","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Hellenic Journal of Cardiology"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.hjc.2026.09.002","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:17:00Z","timestamp":1790723820000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of a troponin I-adapted modified GRACE score: a cohort study"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7609-0087","authenticated-orcid":false,"given":"Dimitrios","family":"Delialis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Georgiopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Chrysochou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Spray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8245-7287","authenticated-orcid":false,"given":"Simon","family":"Kraler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Nastatos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4242-1646","authenticated-orcid":false,"given":"Polyxeni","family":"Manifava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5937-4117","authenticated-orcid":false,"given":"Christina","family":"Konstantaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros","family":"Athanasopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannis","family":"Skoumas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Pitsavos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia-Panagiota","family":"Giannakopoulouc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Mavraganis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kateryna","family":"Sopova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Angeliki","family":"Dimopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Papoutsis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achilleas A.","family":"Zacharoulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Stellos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioakim","family":"Spyridopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8583-153X","authenticated-orcid":false,"given":"Demosthenes","family":"Panagiotakos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6444-8734","authenticated-orcid":false,"given":"Kimon","family":"Stamatelopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.hjc.2026.09.002_bib1","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hjc.2026.09.002_bib2","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1093\/eurheartj\/ehaa575","article-title":"2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation","volume":"42","author":"Collet","year":"2021","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hjc.2026.09.002_bib3","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","volume":"39","author":"Ibanez","year":"2017","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hjc.2026.09.002_bib4","first-page":"e18","article-title":"2021 ACC\/AHA\/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines","volume":"145","author":"Lawton","year":"2022","journal-title":"Circulation"},{"key":"10.1016\/j.hjc.2026.09.002_bib5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2013-004425","article-title":"Should patients with acute coronary disease be stratified for management according to their risk? Derivation, external validation and outcomes using the updated GRACE risk score","volume":"4","author":"Fox","year":"2014","journal-title":"BMJ Open"},{"key":"10.1016\/j.hjc.2026.09.002_bib6","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1136\/bmj.38985.646481.55","article-title":"Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE)","volume":"333","author":"Fox","year":"2006","journal-title":"BMJ"},{"key":"10.1016\/j.hjc.2026.09.002_bib7","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1161\/CIR.0000000000000133","article-title":"2014 AHA\/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"130","author":"Amsterdam","year":"2014","journal-title":"Circulation"},{"key":"10.1016\/j.hjc.2026.09.002_bib8","doi-asserted-by":"crossref","first-page":"2866","DOI":"10.1093\/eurheartj\/ehaf289","article-title":"Acute coronary syndromes: mechanisms, challenges, and new opportunities","volume":"46","author":"Kraler","year":"2025","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hjc.2026.09.002_bib9","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1136\/heartjnl-2021-319225","article-title":"Prognostic value of admission high-sensitivity troponin in patients with ST-elevation myocardial infarction","volume":"107","author":"Coelho-Lima","year":"2021","journal-title":"Heart"},{"key":"10.1016\/j.hjc.2026.09.002_bib10","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1373\/clinchem.2016.256305","article-title":"Incidence of undetectable, measurable, and increased cardiac troponin I concentrations above the 99th percentile using a high-sensitivity vs a contemporary assay in patients presenting to the emergency department","volume":"62","author":"Love","year":"2016","journal-title":"Clin Chem"},{"key":"10.1016\/j.hjc.2026.09.002_bib11","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.ahj.2014.10.007","article-title":"Comparison of conventional and high-sensitivity troponin in patients with chest pain: a collaborative meta-analysis","volume":"169","author":"Lipinski","year":"2015","journal-title":"Am Heart J"},{"key":"10.1016\/j.hjc.2026.09.002_bib12","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/S0140-6736(18)31923-8","article-title":"High-sensitivity troponin in the evaluation of patients with suspected acute coronary syndrome: a stepped-wedge, cluster-randomised controlled trial","volume":"392","author":"Shah","year":"2018","journal-title":"Lancet"},{"key":"10.1016\/j.hjc.2026.09.002_bib13","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1001\/jamacardio.2023.2741","article-title":"Modification of the GRACE risk score for risk prediction in patients with acute coronary syndromes","volume":"8","author":"Georgiopoulos","year":"2023","journal-title":"JAMA Cardiol"},{"key":"10.1016\/j.hjc.2026.09.002_bib14","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1016\/j.jacc.2023.03.403","article-title":"Myocardial injury thresholds for 4 high-sensitivity troponin assays in U.S. adults","volume":"81","author":"McEvoy","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hjc.2026.09.002_bib15","article-title":"Use of high-sensitivity cardiac troponin in the emergency department: a policy resource and education paper (PREP) from the American College of Emergency Physicians","volume":"4","author":"Promes","year":"2023","journal-title":"J Am Coll Emerg Phys Open"},{"key":"10.1016\/j.hjc.2026.09.002_bib16","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1016\/j.jacc.2008.01.053","article-title":"Physical activity status and acute coronary syndromes survival","volume":"51","author":"Pitsavos","year":"2008","journal-title":"JACC"},{"key":"10.1016\/j.hjc.2026.09.002_bib17","doi-asserted-by":"crossref","DOI":"10.1177\/15598276251347894","article-title":"Twenty-year trajectories of physical activity and acute coronary syndrome incidence; the GREECS epidemiological study (2004-2024)","author":"Dimitriadis","year":"2025","journal-title":"Am J Lifestyle Med"},{"key":"10.1016\/j.hjc.2026.09.002_bib18","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.1001\/archinte.163.19.2345","article-title":"Predictors of hospital mortality in the global registry of acute coronary events","volume":"163","author":"Granger","year":"2003","journal-title":"Arch Intern Med"},{"key":"10.1016\/j.hjc.2026.09.002_bib19","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2022-001984","article-title":"External validation of the GRACE risk score and the risk-treatment paradox in patients with acute coronary syndrome","volume":"9","author":"van der Sangen","year":"2022","journal-title":"Open Heart"},{"key":"10.1016\/j.hjc.2026.09.002_bib20","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1093\/aje\/kws207","article-title":"Interpreting incremental value of markers added to risk prediction models","volume":"176","author":"Pencina","year":"2012","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.hjc.2026.09.002_bib21","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-073843","article-title":"Effectiveness of GRACE risk score in patients admitted to hospital with non-ST elevation acute coronary syndrome (UKGRIS): parallel group cluster randomised controlled trial","volume":"381","author":"Gale","year":"2023","journal-title":"BMJ"},{"key":"10.1016\/j.hjc.2026.09.002_bib22","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1186\/s12913-022-07750-8","article-title":"Objective risk assessment vs standard care for acute coronary syndromes-The Australian GRACE risk tool implementation study (AGRIS): a process evaluation","volume":"22","author":"Gullick","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.hjc.2026.09.002_bib23","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1001\/jamacardio.2020.6314","article-title":"Objective risk assessment vs standard care for acute coronary syndromes: a randomized clinical trial","volume":"6","author":"Chew","year":"2021","journal-title":"JAMA Cardiol"},{"key":"10.1016\/j.hjc.2026.09.002_bib24","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1161\/CIRCOUTCOMES.108.831198","article-title":"C-Reactive protein and reclassification of cardiovascular risk in the Framingham Heart Study","volume":"1","author":"Wilson","year":"2008","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"10.1016\/j.hjc.2026.09.002_bib25","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/sim.2929","article-title":"Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond","volume":"27","author":"Pencina","year":"2008","journal-title":"Stat Med"},{"key":"10.1016\/j.hjc.2026.09.002_bib26","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1016\/j.jacc.2016.01.069","article-title":"Relationship between infarct size and outcomes following primary PCI: patient-level analysis from 10 randomized trials","volume":"67","author":"Stone","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hjc.2026.09.002_bib27","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S0140-6736(22)01483-0","article-title":"Sex-specific evaluation and redevelopment of the GRACE score in non-ST-segment elevation acute coronary syndromes in populations from the UK and Switzerland: a multinational analysis with external cohort validation","volume":"400","author":"Wenzl","year":"2022","journal-title":"Lancet"}],"container-title":["Hellenic Journal of Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1109966626001636?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1109966626001636?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:23:08Z","timestamp":1792408988000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1109966626001636"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":27,"alternative-id":["S1109966626001636"],"URL":"https:\/\/doi.org\/10.1016\/j.hjc.2026.09.002","relation":{},"ISSN":["1109-9666"],"issn-type":[{"value":"1109-9666","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Validation of a troponin I-adapted modified GRACE score: a cohort study","name":"articletitle","label":"Article Title"},{"value":"Hellenic Journal of Cardiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.hjc.2026.09.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Hellenic Society of Cardiology. Publishing services by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}