{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T02:02:57Z","timestamp":1778637777526,"version":"3.51.4"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardiac troponin (cTn) permits early rule\u2010out\/rule\u2010in of patients admitted with possible non\u2013ST\u2010segment\u2013elevation myocardial infarction. In this study, we developed an admission and a 0\/1\u00a0hour rule\u2010out\/rule\u2010in algorithm for a troponin assay with measurable results in &gt;99% of healthy individuals. We then compared its diagnostic and long\u2010term prognostic properties with other protocols.<\/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              Blood samples were collected at 0, 1, 3, and 8 to 12\u00a0hours from patients admitted with possible non\u2013ST\u2010segment\u2013elevation myocardial infarction. cTnT (Roche Diagnostics), cTnI\n              <jats:sub>(Abbott)<\/jats:sub>\n              (Abbott Diagnostics), and cTnI\n              <jats:sub>(sgx)<\/jats:sub>\n              (Singulex Clarity System) were measured in 971 admission and 465 1\u2010hour samples. An admission and a 0\/1\u00a0hour rule\u2010out\/rule\u2010in algorithm were developed for the cTnI\n              <jats:sub>(sgx)<\/jats:sub>\n              assay and its diagnostic properties were compared with cTnT\n              <jats:sub>ESC<\/jats:sub>\n              (European Society of Cardiology), cTnI\n              <jats:sub>(Abbott)ESC<\/jats:sub>\n              , and 2 earlier cTnI\n              <jats:sub>(sgx)<\/jats:sub>\n              algorithms. The prognostic composite end point was all\u2010cause mortality and future nonfatal myocardial infarction during a median follow\u2010up of 723\u00a0days. non\u2013ST\u2010segment\u2013elevation myocardial infarction prevalence was 13%. The novel cTnI\n              <jats:sub>(sgx)<\/jats:sub>\n              algorithms showed similar performance regardless of time from symptom onset, and area under the curve was significantly better than comparators. The cTnI\n              <jats:sub>(sgx)0\/1\u00a0hour<\/jats:sub>\n              algorithm classified 92% of patients to rule\u2010in or rule\u2010out compared with \u226478% of comparators. Patients allocated to rule\u2010out by the prior published 0\/1\u00a0hour algorithms had significantly fewer long\u2010term events compared with the rule\u2010in and observation groups. The novel cTnI\n              <jats:sub>(sgx)0\/1\u00a0hour<\/jats:sub>\n              algorithm used a higher troponin baseline concentration for rule\u2010out and did not allow for prognostication.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Increasingly sensitive troponin assays may improve identification of non\u2013ST\u2010segment\u2013elevation myocardial infarction but could rule\u2010out patients with subclinical chronic myocardial injury. Separate protocols for diagnosis and risk prediction seem appropriate.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017465","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T10:00:48Z","timestamp":1606384848000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Cardiac Troponin Assays With Improved Analytical Quality: A Trade\u2010Off Between Enhanced Diagnostic Performance and Reduced Long\u2010Term Prognostic Value"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2577-5497","authenticated-orcid":false,"given":"Hilde L.","family":"Tjora","sequence":"first","affiliation":[{"name":"Emergency Care Clinic Haukeland University Hospital Bergen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2520-9436","authenticated-orcid":false,"given":"Ole\u2010Thomas","family":"Steiro","sequence":"additional","affiliation":[{"name":"Department of Heart Disease Haukeland University Hospital Bergen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f8rund","family":"Lang\u00f8rgen","sequence":"additional","affiliation":[{"name":"Department of Heart Disease Haukeland University Hospital Bergen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6637-5743","authenticated-orcid":false,"given":"Rune","family":"Bj\u00f8rneklett","sequence":"additional","affiliation":[{"name":"Emergency Care Clinic Haukeland University Hospital Bergen Norway"},{"name":"Department of Clinical Medicine University of Bergen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ottar K.","family":"Nyg\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Heart Disease Haukeland University Hospital Bergen Norway"},{"name":"Department of Clinical Science University of Bergen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d8yvind","family":"Skadberg","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Biochemistry Stavanger University Hospital Stavanger Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vernon V. 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