{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T22:44:06Z","timestamp":1768776246945,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2011,11,11]],"date-time":"2011-11-11T00:00:00Z","timestamp":1320969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Internal Medicine"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:p><jats:bold>Abstract.\u2002<\/jats:bold> Arenja N, Reichlin T, Drexler B, Oshima S, Denhaerynck K, Haaf P, Potocki M, Breidthardt T, Noveanu M, Stelzig C, Heinisch C, Twerenbold R, Reiter M, Socrates T, Mueller C (University Hospital, Basel). Sensitive cardiac troponin in the diagnosis and risk stratification of acute heart failure. <jats:italic>J Intern Med<\/jats:italic> 2012; <jats:bold>271<\/jats:bold>: 598\u2013607.<\/jats:p><jats:p><jats:bold>Background.\u2002<\/jats:bold> The aim of our study was to investigate the diagnostic and prognostic value of a sensitive cardiac troponin I (s\u2010cTnI) assay in patients with acute heart failure (AHF).<\/jats:p><jats:p><jats:bold>Methods.\u2002<\/jats:bold> Sensitive cardiac troponin I was measured in 667 consecutive patients at presentation to the emergency department with acute dyspnoea. Three s\u2010cTnI strata were predefined: below the limit of detection (&lt;0.01\u2003\u03bcg\u2003L<jats:sup>\u22121<\/jats:sup>, undetectable), detectable but still within the normal range (0.01\u20130.027\u2003\u03bcg\u2003L<jats:sup>\u22121<\/jats:sup>) and increased (\u22650.028\u2003\u03bcg\u2003L<jats:sup>\u22121<\/jats:sup>, \u226599th percentile). The final diagnosis was adjudicated by two independent cardiologists blinded to the s\u2010cTnI levels. Median follow\u2010up in patients with AHF was 371\u2003days.<\/jats:p><jats:p><jats:bold>Results.\u2002<\/jats:bold> Levels of s\u2010cTnI were higher in patients with AHF (<jats:italic>n\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>377, 57%) compared to patients with noncardiac causes of acute dyspnoea (median 0.02 vs. &lt;0.01\u2003\u03bcg\u2003L<jats:sup>\u22121<\/jats:sup>, <jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.001). In patients with AHF, in\u2010hospital mortality increased with increasing s\u2010cTnI in the three strata (2%, 5% and 14%, <jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.001). One\u2010year mortality also increased with increasing s\u2010cTnI (21%, 33% and 47%, <jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.001). s\u2010cTnI remained an independent predictor of 1\u2010year mortality [adjusted odds ratio 1.03 for each increase of 0.1\u2003\u03bcg\u2003L<jats:sup>\u22121<\/jats:sup>, 95% confidence interval (CI) 1.02\u20131.05, <jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.001] after adjustment for other risk factors including B\u2010type natriuretic peptide. The net reclassification improvement was 68% (<jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.001), and absolute integrated discrimination improvement was 0.18 (<jats:italic>P\u2003<\/jats:italic>&lt;<jats:italic>\u2003<\/jats:italic>0.001). The diagnostic accuracy of s\u2010cTnI for the diagnosis of AHF as quantified by the area under the receiver operating characteristic curve was 0.78 (95% CI, 0.75\u20130.82).<\/jats:p><jats:p><jats:bold>Conclusions.\u2002<\/jats:bold> Sensitive cardiac troponin I is a strong predictor of short\u2010 and long\u2010term prognosis in AHF that helps to reclassify patients in terms of mortality risk. Detectable levels of s\u2010cTnI, even within the normal range, are independently associated with mortality.<\/jats:p>","DOI":"10.1111\/j.1365-2796.2011.02469.x","type":"journal-article","created":{"date-parts":[[2011,10,11]],"date-time":"2011-10-11T17:59:09Z","timestamp":1318355949000},"page":"598-607","source":"Crossref","is-referenced-by-count":46,"title":["Sensitive cardiac troponin in the diagnosis and risk stratification of acute heart 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