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However, macrotroponin, a complex of cTnI and endogenous cardiac troponin autoantibodies, may artefactually elevate cTnI levels with potential to mislead clinicians, leading to inappropriate investigation and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the prevalence and trajectory of macrotroponin in participants of the prospective community\u2010based SCreening Evaluation of the Evolution of New Heart Failure (SCREEN\u2010HF) study cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Inclusion criteria were age \u2265\u200960\u2009years with one or more self\u2010reported ischaemic or other heart diseases, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment or treatment for hypertension or diabetes for \u22652\u2009years. Exclusion criteria were known heart failure or cardiac abnormality on echocardiography or other imaging. A cutoff residual cTnI activity \u226420% after polyethylene glycol precipitation was used to detect macrotroponin in plasma samples with cTnI levels above the sex\u2010specific 99th percentile reference limits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 3156 SCREEN\u2010HF participants with one or more cTnI measurements, 64 (2%) had macrotroponin. Among 2243 participants with two or more cTnI measurements, cTnI levels with macrotroponin were dynamic, although most elevated cTnI levels with macrotroponin at baseline remained elevated (14 of 16 men, 9 of 11 women) for several years during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated cTnI levels with macrotroponin remained elevated for several years in asymptomatic individuals in this community\u2010based cohort. While interpreting elevated cTnI levels in the clinical context, recording macrotroponin as a diagnosis could alert clinicians to possible artefactual elevation of cTnI levels during subsequent clinical presentation and avoid inappropriate investigation and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70618","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:02:21Z","timestamp":1789038141000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trajectory of macrotroponin in a community cohort"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6896-7571","authenticated-orcid":false,"given":"Duncan J.","family":"Campbell","sequence":"first","affiliation":[{"name":"Department of Cardiology St. Vincent's Hospital  Melbourne Victoria Australia"},{"name":"Laboratory of Molecular Cardiology St. Vincent's Institute of Medical Research  Melbourne Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei Fei","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"McGrady","sequence":"additional","affiliation":[{"name":"Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Prior","sequence":"additional","affiliation":[{"name":"Department of Cardiology St. Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Reid","sequence":"additional","affiliation":[{"name":"Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"School of Population Health Curtin University  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M.","family":"Trambas","sequence":"additional","affiliation":[{"name":"Department of Pathology St. Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy462"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2015-1276"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/00045632231197301"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.035128"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.125.076296"},{"key":"e_1_2_9_7_1","first-page":"956e5","article-title":"Macrotroponin causing elevation in cardiac troponin I","volume":"30","author":"Wong SL","year":"2014","journal-title":"Can J Cardiol"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab924"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2017.07.40"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2016.07.018"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13678"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2018-000782"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1381"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_9_15_1","unstructured":"The International Federation of Clinical Chemistry Committee on Clinical Applications of Cardiac Bio\u2010markers.High\u2010sensitivity cardiac troponin I and T assay analytical characteristics designated by manufacturer. 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