{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:35Z","timestamp":1787017055132,"version":"build-2736575974"},"reference-count":46,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"unspecified","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["3690\/7-1"],"award-info":[{"award-number":["3690\/7-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["BR 6028\/2-1"],"award-info":[{"award-number":["BR 6028\/2-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["BMBF 01ER1206"],"award-info":[{"award-number":["BMBF 01ER1206"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["BMBF 01ER1507"],"award-info":[{"award-number":["BMBF 01ER1507"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005296","name":"Universit\u00e4tsklinikum Regensburg","doi-asserted-by":"publisher","award":["ReForM-B"],"award-info":[{"award-number":["ReForM-B"]}],"id":[{"id":"10.13039\/501100005296","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010578","name":"Deutsche Gesellschaft f\u00fcr Kardiologie-Herz und Kreislaufforschung.","doi-asserted-by":"publisher","award":["DGK-Forschungsstipendium"],"award-info":[{"award-number":["DGK-Forschungsstipendium"]}],"id":[{"id":"10.13039\/501100010578","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,5]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>European guidelines recommended a uniform upper reference limit of high-sensitivity cardiac troponin T (hsTnT) to rule out non-ST segment elevation myocardial infarction. Our study aimed to provide a hsTnT reference distribution and to assess the specificity of the 14\u2009ng\/L cut-off value in the mobile population \u226570\u2009years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      A cross-sectional analysis was performed in the German AugUR study (\n                      <jats:italic>A<\/jats:italic>\n                      ltersbezogene\n                      <jats:italic>U<\/jats:italic>\n                      ntersuchungen zur\n                      <jats:italic>G<\/jats:italic>\n                      esundheit der\n                      <jats:italic>U<\/jats:italic>\n                      niversity of\n                      <jats:italic>R<\/jats:italic>\n                      egensburg).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Study population was the mobile population aged 70+ years living in the city and county of Regensburg, Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A random sample was derived from the local population registries of residence. Of the 5644 individuals invited, 1133 participated (response ratio=20.1%). All participants came to the study centre and were mentally and physically mobile to conduct the protocol (face-to-face interview, blood draw and standardised transthoracic echocardiography). None of the participants was in an acute state of myocardial infarction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 1129 individuals with hsTnT measurements (overall median=10.0\u2009ng\/L<\/jats:p>\n                    <jats:p>\n                      (25th, 75th percentile)=(7.0, 15.0\u2009ng\/L)), hsTnT was higher among the older individuals and higher among men (men 70\u201374 years median=9.6\u2009ng\/L (7.2, 13.1\u2009ng\/L); men 90\u201395 years median=21.2\u2009ng\/L (14.6, 26.0\u2009ng\/L); women 70\u201374 years median=6.3\u2009ng\/L (4.7, 8.7\u2009ng\/L); and women 90\u201395 years median=18.0\u2009ng\/L (11.0, 21.0\u2009ng\/L)). In participants with impaired kidney function (eGFR\n                      <jats:sub>crea<\/jats:sub>\n                      &lt;60\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ), hsTnT was elevated (median=13.6\u2009ng\/L (9.4, 20.6\u2009ng\/L)).\n                    <\/jats:p>\n                    <jats:p>Specificity of recommended upper reference limit, 14\u2009ng\/L, is 68%. Most false positives were among men aged &gt;79\u2009years (specificity=34%). In a healthy subgroup (n=96, none of the following: overt heart disease, impaired renal function, blood pressure &gt;160\/100\u2009mm Hg, left ventricular hypertrophy and diastolic\/systolic dysfunction), specificity was 90%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the elderly population without acute myocardial infarction, hsTnT further increases with age showing different levels for men and women. The specificity of the 14\u2009ng\/L cut-off is considerably lower than 99%, even in healthy subjects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-052004","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T15:35:34Z","timestamp":1635867334000},"page":"e052004","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Distribution and specificity of high-sensitivity cardiac troponin T in older adults without acute cardiac conditions: cross-sectional results from the population-based AugUR study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4091-8620","authenticated-orcid":false,"given":"Alexander","family":"Dietl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina E","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Brandl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Wallner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Burkhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars S","family":"Maier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Luchner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris M","family":"Heid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus J","family":"Stark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"2024102804502908000_11.11.e052004.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa624"},{"key":"2024102804502908000_11.11.e052004.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000617"},{"key":"2024102804502908000_11.11.e052004.3","first-page":"428","article-title":"[Case report: Aneurysmatic subarachnoid hemorrhage -- complicated course due to coincidental manifestation of an inverted Tako-Tsubo-cardiomyopathy]","volume":"49","author":"Zech","year":"2014","journal-title":"Anasthesiol Intensivmed Notfallmed Schmerzther"},{"key":"2024102804502908000_11.11.e052004.4","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2009.132654"},{"key":"2024102804502908000_11.11.e052004.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2010.12.034"},{"key":"2024102804502908000_11.11.e052004.6","doi-asserted-by":"crossref","first-page":"3780","DOI":"10.1093\/eurheartj\/ehy514","article-title":"Impact of age on the performance of the ESC 0\/1h-algorithms for early diagnosis of myocardial infarction","volume":"39","author":"Boeddinghaus","year":"2018","journal-title":"Eur Heart J"},{"key":"2024102804502908000_11.11.e052004.7","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028901"},{"key":"2024102804502908000_11.11.e052004.8","doi-asserted-by":"crossref","unstructured":"Cockburn J , Kemp T , Ludman P , et al . 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