{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T22:06:40Z","timestamp":1769206000897,"version":"3.49.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,4,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Methadone poisoning\/overdose is a global public health problem. We aimed to determine whether methadone poisoning increased cardiac troponin and whether high\u2010sensitivity cardiac troponin I (hs\u2010cTnI) levels predicted the need for intensive care unit admission, intubation, and mortality.<\/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              This observational, prospective single\u2010center study was done at Loghman\u2010Hakim Hospital (Tehran, Iran) from June 2018 until February 2019. Patients aged &gt;14\u00a0years admitted with a diagnosis of methadone exposure were included. Patients were excluded if they had coexisting conditions associated with elevated hs\u2010cTnI levels. An ECG and hs\u2010cTnI levels were obtained on emergency department presentation. Patients were followed up on their need for intubation, intensive care unit admission, and in\u2010hospital mortality. Of 245 included patients (186 [75.9%] men; median age, 33\u00a0years), most referred to loss of consciousness (210 cases, 89%). Nineteen (7.7%) patients had hs\u2010cTnI levels of &gt;0.1\u00a0ng\/mL (positive), and 41 (16.7%) had borderline levels of 0.019 to 0.1\u00a0ng\/mL. Twenty\u2010three (9.3%) cases were admitted to the intensive care unit, 21 (8.5%) needed intubation, and 5 (2%) died during hospitalization. An hs\u2010cTnI cutoff value of 0.019\u00a0ng\/mL independently predicted mortality. For optimal concomitant sensitivity and specificity, receiver operating characteristic curve analysis was conducted and showed that hs\u2010cTnI had an independent significant association with mortality, with a cutoff value of 0.0365\u00a0ng\/mL (odds ratio, 38.1; 95% CI, 2.3\u2013641.9;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Methadone exposure\/toxicity is a newly identified cause of elevated hs\u2010cTnI. Values &gt;0.019\u00a0ng\/mL, and particularly &gt;0.0365\u00a0ng\/mL, of hs\u2010cTnI predicted mortality in our sample. Future studies should measure troponin levels in methadone maintenance treatment clients to assess the risk of myocardial injury from long\u2010term exposure.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.018899","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T09:51:32Z","timestamp":1617702692000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Troponin, A Predictor of Mortality in Methadone Exposure: An Observational Prospective Study"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7528-8155","authenticated-orcid":false,"given":"Mehdi","family":"Sheibani","sequence":"first","affiliation":[{"name":"Cardiovascular Research CenterShahid Beheshti University of Medical Sciences Tehran Iran"},{"name":"Clinical Research Development Center of Loghman Hakim HospitalShahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4431-244X","authenticated-orcid":false,"given":"Akram Alsadat","family":"Mirfallah Nassiri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7140-3136","authenticated-orcid":false,"given":"Amirhossein","family":"Abedtash","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3373-4943","authenticated-orcid":false,"given":"Rebecca","family":"McDonald","sequence":"additional","affiliation":[{"name":"King's College London National Addiction CentreInstitute of Psychiatry, Psychology and Neuroscience London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2091-0197","authenticated-orcid":false,"given":"Nasim","family":"Zamani","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research CenterShahid Beheshti University of Medical Sciences Tehran Iran"},{"name":"Department of Clinical Toxicology Loghman\u2010Hakim HospitalSchool of MedicineShahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4370-0544","authenticated-orcid":false,"given":"Hossein","family":"Hassanian\u2010Moghaddam","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research CenterShahid Beheshti University of Medical Sciences Tehran Iran"},{"name":"Department of Clinical Toxicology Loghman\u2010Hakim HospitalSchool of MedicineShahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-800634-4.00053-6"},{"key":"e_1_3_2_3_2","first-page":"S5","article-title":"Opioids in the management of chronic non\u2010cancer pain: an update of American Society of the Interventional Pain Physicians\u2019(ASIPP) Guidelines","volume":"11","author":"Trescot AM","year":"2008","unstructured":"Trescot AM, Helm S, Hansen H, Benyamin R, Glaser SE, Adlaka R, Patel S, Manchikanti L. 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