{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:49:59Z","timestamp":1791470999148,"version":"4.3.4"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,1,16]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">We aimed to identify patients with subphenotypes of postacute coronary syndrome (ACS) using repeated measurements of high\u2010sensitivity cardiac troponin T, N\u2010terminal pro\u2010B\u2010type natriuretic peptide, high\u2010sensitivity C\u2010reactive protein, and growth differentiation factor 15 in the year after the index admission, and to investigate their association with long\u2010term mortality risk.<\/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                      BIOMArCS (BIOMarker Study to Identify the Acute Risk of a Coronary Syndrome) was an observational study of patients with ACS, who underwent high\u2010frequency blood sampling for 1\u2009year. Biomarkers were measured in a median of 16 repeated samples per individual. Cluster analysis was performed to identify biomarker\u2010based subphenotypes in 723 patients without a repeat ACS in the first year. Patients with a repeat ACS (N=36) were considered a separate cluster. Differences in all\u2010cause death were evaluated using accelerated failure time models (median follow\u2010up, 9.1\u2009years; 141 deaths). Three biomarker\u2010based clusters were identified: cluster 1 showed low and stable biomarker concentrations, cluster 2 had elevated concentrations that subsequently decreased, and cluster 3 showed persistently elevated concentrations. The temporal biomarker patterns of patients in cluster 3 were similar to those with a repeat ACS during the first year. Clusters 1 and 2 had a similar and favorable long\u2010term mortality risk. Cluster 3 had the highest mortality risk. The adjusted survival time ratio was 0.64 (95% CI, 0.44\u20130.93;\n                      <jats:italic>P<\/jats:italic>\n                      =0.018) compared with cluster 1, and 0.71 (95% CI, 0.39\u20131.32;\n                      <jats:italic>P<\/jats:italic>\n                      =0.281) compared with patients with a repeat ACS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with subphenotypes of post\u2010ACS with different all\u2010cause mortality risks during long\u2010term follow\u2010up can be identified on the basis of repeatedly measured cardiovascular biomarkers. Patients with persistently elevated biomarkers have the worst outcomes, regardless of whether they experienced a repeat ACS in the first year.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.031646","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T06:17:47Z","timestamp":1705040267000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Acute Coronary Syndrome Subphenotypes Based on Repeated Biomarker Measurements in Relation to Long\u2010Term Mortality Risk"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4883-2805","authenticated-orcid":false,"given":"Marie","family":"de Bakker","sequence":"first","affiliation":[{"name":"Department of Cardiology Erasmus MC, University Medical Center Rotterdam Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-888X","authenticated-orcid":false,"given":"Niels T. 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