{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:33:56Z","timestamp":1793115236163,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014438","name":"Business Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014438","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005633","name":"Finnish Foundation for Cardiovascular Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and hypothesis<\/jats:title>\n                    <jats:p>A recently developed cardiac troponin T (cTnT) assay measuring intact or mildly fragmented cTnT (long cTnT) has shown promise in improving the accuracy of myocardial infarction (MI) detection compared to the commercial high-sensitivity cTnT (hs-cTnT) assay. However, data on patients with kidney dysfunction are limited. We compared the performance of long and hs-cTnT in MI diagnostics across the full spectrum of kidney function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, consecutive patients presenting at the emergency department with an elevated (\u226514\u00a0ng\/l) hs-cTnT were recruited. Long and hs-cTnT were measured on admission and kidney function was determined with plasma creatinine (Crea), cystatin C (CysC), and estimated glomerular filtration rate (eGFR) using contemporary equations with Crea, CysC, or both (Crea\u2013CysC) together. The association of eGFR with hs-cTnT and long cTnT concentrations and the discriminative ability of hs-cTnT and long cTnT for type 1 MI and any MI were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 1811 patients were included, 205 (11.3%) had an MI and 204 (11.3%) had a history of chronic kidney disease. The overall median (interquartile range) Crea-eGFR, CysC-eGFR, and Crea\u2013CysC-eGFR were 71 (51\u201387), 52 (36\u201369), and 63 (44\u201379) ml\/min\/1.73\u00a0m2. In patients without MI, long cTnT showed no consistent association with kidney function (\u03b2\u00a0=\u00a00.0008, P\u00a0=\u00a00.050; \u03b2\u00a0=\u00a00.0005, P\u00a0=\u00a00.222; \u03b2\u00a0=\u00a00.0006, P\u00a0=\u00a00.182 for Crea-eGFR, CysC-eGFR, and Crea\u2013CysC-eGFR, respectively), whereas hs-cTnT was inversely associated with kidney function (\u03b2\u00a0=\u00a0\u22120.0032, \u22120.0035, and \u22120.0035; all P\u00a0&amp;lt;\u00a00.001). Long cTnT demonstrated superior diagnostic performance compared with hs-cTnT for the detection of MI (P\u00a0&amp;lt;\u00a00.001), with the advantage becoming progressively more pronounced with lower eGFR irrespective of equation used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In contrast to hs-cTnT, long cTnT is unaffected by kidney function and outperforms hs-cTnT in the detection of MI, with the greatest diagnostic advantage observed in patients with lower eGFR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfag239","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:52:28Z","timestamp":1792151548000},"source":"Crossref","is-referenced-by-count":0,"title":["Long forms of cardiac troponin T are independent of kidney function and improve the diagnosis of myocardial infarction"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9453-5687","authenticated-orcid":false,"given":"Tapio","family":"Hellman","sequence":"first","affiliation":[{"name":"Kidney Center, Turku University Hospital and University of Turku , Turku ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4460-0994","authenticated-orcid":false,"given":"Konsta","family":"Teppo","sequence":"additional","affiliation":[{"name":"Cardiac Unit, Division of Internal Medicine , Satasairaala, Pori ,","place":["Finland"]},{"name":"University of Turku Department of Internal Medicine, , Turku ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Linko-Parvinen","sequence":"additional","affiliation":[{"name":"Clinical Chemistry, Tyks Laboratories, Turku University Hospital , Turku ,","place":["Finland"]},{"name":"University of Turku Department of Clinical Chemistry, , Turku ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna-Mari","family":"Pallari","sequence":"additional","affiliation":[{"name":"Clinical Chemistry, Tyks Laboratories, Turku University Hospital , Turku ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helea","family":"Junes","sequence":"additional","affiliation":[{"name":"University of Turku Biotechnology Unit, Department of Life Technologies, , Turku ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuulia","family":"Tuominen","sequence":"additional","affiliation":[{"name":"University of Turku Biotechnology Unit, Department of Life Technologies, , Turku ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selma","family":"Salonen","sequence":"additional","affiliation":[{"name":"University of Turku Biotechnology Unit, Department of Life Technologies, , Turku 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