{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:23:27Z","timestamp":1793237007118,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Finnish Foundation"},{"name":"Cardiovascular Research and Clinical Research Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Elevated cardiac troponin levels are a frequent finding in emergency department patients, often without a clear cause. Current high-sensitivity cardiac troponin T (cTnT) assays measure intact and fragmented cardiac troponin T (total cTnT) molecules, without distinguishing between them. This study investigated whether measuring only intact and minimally fragmented cTnT (long cTnT) provides additional value for myocardial infarction (MI) identification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive emergency department patients with standard high-sensitivity cTnT levels (Roche Diagnostics) above the upper reference limit (\u226514\u2005ng\/L) were recruited. Long cTnT levels were measured using a novel immunoassay. The additional diagnostic value of long cTnT in identifying patients with type 1 MI or any MI was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1811 patients participated in the study, 1145 (63.2%) presenting with chest pain or dyspnoea. Overall, 205 (11.3%) had MI, including 148 classified as type 1 MI. Only .7% of patients in the lowest long cTnT tertile (&amp;lt;3.7\u2005ng\/L) had type 1 MI. The discriminative ability of long cTnT was superior to total cTnT in identifying patients with MI (area under curve [95% confidence intervals]) for any MI: .833 (.804\u2013.863) vs .782 (.744\u2013.819), and for type 1 MI: .839 (.807\u2013.872) vs .777 (.735\u2013.819), both (P &amp;lt; .001). Integrating the predictive data from long cTnT with total cTnT provided additional value in both reclassification and decision curve analyses, compared to total cTnT data alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The long cTnT assay demonstrated good diagnostic performance in identifying MI in patients with elevated total cTnT levels, with the potential to improve the accuracy of MI diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaf975","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T12:35:20Z","timestamp":1763382920000},"page":"490-499","source":"Crossref","is-referenced-by-count":18,"title":["Long forms of cardiac troponin T for myocardial infarction diagnosis: the SuperTROPO 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