{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:50:38Z","timestamp":1753887038247,"version":"3.41.2"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,6,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              High\u2010sensitivity cardiac troponins T and I (hs\u2010\n              <jats:styled-content style=\"fixed-case\">cTnT<\/jats:styled-content>\n              and hs\u2010\n              <jats:styled-content style=\"fixed-case\">cTnI<\/jats:styled-content>\n              ) are established biomarkers for myocardial injury and used for diagnostic and prognostic purposes. However, whether repeat measurements improve prediction of recurrent cardiovascular disease (\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              ) events in patients with stable coronary heart disease (\n              <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n              ) after adjustment for several other novel biomarkers remains unclear.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We measured both troponins in 873 coronary heart disease patients from the KAROLA (Langzeiterfolge der Kardiologischen Anschlussheilbehandlung) study about 9\u00a0weeks after their initial acute event (baseline) and after 12\u00a0months, followed them for 12\u00a0years, assessed a combined\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              end point, and adjusted for several risk factors. As we found evidence for effect modification, results were stratified according to presence of myocardial infarction at baseline. During follow\u2010up, 186 fatal and non\u2010fatal\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              events occurred. Both baseline and 12\u2010months troponin concentrations were significantly associated with\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              events in patients without myocardial infarction at baseline; in tendency 12 months of troponin showed stronger hazard ratios (hs\u2010\n              <jats:styled-content style=\"fixed-case\">cTnT<\/jats:styled-content>\n              : hazard ratios 1.91 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.17\u20133.11) versus baseline values 1.71 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.08\u20132.70) and for hs\u2010\n              <jats:styled-content style=\"fixed-case\">cTnI<\/jats:styled-content>\n              : hazard ratio 1.55 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.05\u20132.30) versus baseline value 1.22 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.88\u20131.68) in the fully and simultaneously adjusted model.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Both troponins are consistently associated with recurrent cardiovascular events after adjustment for emerging risk\u00a0factors during follow\u2010up in our study especially evident in patients without myocardial infarction at baseline. Troponin values at 12 months of follow\u2010up showed independent associations with future\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              events in addition to baseline assessments of troponins.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.011882","type":"journal-article","created":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T09:02:20Z","timestamp":1560416540000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Repeat Measurements of High Sensitivity Troponins for the Prediction of Recurrent Cardiovascular Events in Patients With Established Coronary Heart Disease: An Analysis From the KAROLA Study"],"prefix":"10.1161","volume":"8","author":[{"given":"Henning","family":"Jansen","sequence":"first","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen Technische Universit\u00e4t M\u00fcnchen Munich Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance Technische Universit\u00e4t M\u00fcnchen Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Jaensch","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry Ulm University Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Sch\u00f6ttker","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology and Aging Research C070 German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"Network Ageing Research University of Heidelberg Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhayana","family":"Dallmeier","sequence":"additional","affiliation":[{"name":"AGAPLESION Bethesda Clinic Geriatric Center Ulm Research Unit on Aging Ulm University Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Schmucker","sequence":"additional","affiliation":[{"name":"Klinik Schwabenland Isny\u2010Neutrauchburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hermann","family":"Brenner","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology and Aging Research C070 German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Koenig","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen Technische Universit\u00e4t M\u00fcnchen Munich Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance Technische Universit\u00e4t M\u00fcnchen Munich Germany"},{"name":"Department of Internal Medicine II\u2010Cardiology University of Ulm Medical Centre Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietrich","family":"Rothenbacher","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry Ulm University Ulm Germany"},{"name":"Division of Clinical Epidemiology and Aging Research C070 German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"doi-asserted-by":"publisher","key":"e_1_3_1_2_2","DOI":"10.1056\/NEJMoa1002358"},{"doi-asserted-by":"publisher","key":"e_1_3_1_3_2","DOI":"10.1161\/CIR.0000000000000617"},{"doi-asserted-by":"publisher","key":"e_1_3_1_4_2","DOI":"10.1093\/eurheartj\/eht406"},{"doi-asserted-by":"publisher","key":"e_1_3_1_5_2","DOI":"10.1016\/j.jacc.2012.12.026"},{"doi-asserted-by":"publisher","key":"e_1_3_1_6_2","DOI":"10.1016\/j.ijcard.2017.08.062"},{"doi-asserted-by":"publisher","key":"e_1_3_1_7_2","DOI":"10.1016\/j.jacc.2016.10.020"},{"doi-asserted-by":"publisher","key":"e_1_3_1_8_2","DOI":"10.1373\/clinchem.2016.261172"},{"doi-asserted-by":"publisher","key":"e_1_3_1_9_2","DOI":"10.1001\/jamacardio.2016.0765"},{"doi-asserted-by":"publisher","key":"e_1_3_1_10_2","DOI":"10.1016\/j.jacc.2016.04.046"},{"doi-asserted-by":"publisher","key":"e_1_3_1_11_2","DOI":"10.1373\/clinchem.2012.183319"},{"doi-asserted-by":"publisher","key":"e_1_3_1_12_2","DOI":"10.1373\/clinchem.2016.257550"},{"doi-asserted-by":"publisher","key":"e_1_3_1_13_2","DOI":"10.1371\/journal.pone.0117143"},{"doi-asserted-by":"publisher","key":"e_1_3_1_14_2","DOI":"10.1161\/CIRCULATIONAHA.106.672402"},{"doi-asserted-by":"publisher","key":"e_1_3_1_15_2","DOI":"10.1002\/sim.2929"},{"doi-asserted-by":"publisher","key":"e_1_3_1_16_2","DOI":"10.1373\/clinchem.2012.191700"},{"doi-asserted-by":"publisher","key":"e_1_3_1_17_2","DOI":"10.1161\/CIRCULATIONAHA.111.044149"},{"doi-asserted-by":"publisher","key":"e_1_3_1_18_2","DOI":"10.1056\/NEJMoa1415921"},{"doi-asserted-by":"publisher","key":"e_1_3_1_19_2","DOI":"10.1016\/j.ijcard.2015.03.436"},{"doi-asserted-by":"publisher","key":"e_1_3_1_20_2","DOI":"10.1016\/j.jacc.2011.10.875"},{"doi-asserted-by":"publisher","key":"e_1_3_1_21_2","DOI":"10.1007\/s00392-017-1152-8"},{"doi-asserted-by":"publisher","key":"e_1_3_1_22_2","DOI":"10.1016\/j.cca.2017.11.018"},{"doi-asserted-by":"publisher","key":"e_1_3_1_23_2","DOI":"10.1016\/j.jacc.2017.01.077"},{"doi-asserted-by":"publisher","key":"e_1_3_1_24_2","DOI":"10.1373\/clinchem.2011.165795"}],"container-title":["Journal 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