{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:23:35Z","timestamp":1793237015407,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Elevated troponin levels are a frequent finding in patients presenting with atrial fibrillation or atrial flutter (AF) to the emergency department but are seldom caused by myocardial infarction (MI). The current high\u2010sensitivity cTnT (cardiac troponin T) assay measures both the intact and highly fragmented cTnT forms (total cTnT) and detects cTnT elevations in conditions causing myocardial injury or MI without distinction between the 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">The SuperTROPO (Better Diagnostics of Myocardial Infarction With a Test for Special Forms of Troponin) study included 521 consecutive patients with AF only and 188 patients with MI only (139 Type 1 MI), all with a total cTnT value \u226514\u2009ng\/L at emergency department admission. Intact and long forms of cTnT (long cTnT) were analyzed from the first plasma samples using a novel immunoassay. The diagnostic performance of long cTnT and total cTnT assays was compared in these cases with elevated total cTnT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Long cTnT was superior to total cTnT in discriminating troponin elevations in patients with MI from those in patients with AF (area under the curve for type 1 MI: 0.879 versus 0.783; for any MI: 0.864 versus 0.779; both\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) when measured from the first blood sample without a significant effect of sex, age, estimated glomerular filtration rate, or total cTnT &lt;200\u2009ng\/L. The difference in long cTnT levels was most notable in patients presenting within 12\u2009hours of symptom onset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The long cTnT immunoassay shows that the troponin release in AF is composed mainly of smaller troponin fragments. This novel test holds promise that measuring long cTnT forms could help to separate troponin elevations caused by AF from those of acute Type 1 MI from a single sample with better accuracy than the commercial high\u2010sensitivity cTnT test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT05858112.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044092","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T10:19:24Z","timestamp":1772187564000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Long Troponin T to Separate Troponin Elevations Among Patients With Atrial Fibrillation Versus Myocardial Infarction"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0193-568X","authenticated-orcid":false,"given":"K. 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Juhani","family":"Airaksinen","sequence":"first","affiliation":[{"name":"Turku University Hospital","place":["Turku, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4460-0994","authenticated-orcid":false,"given":"Konsta","family":"Teppo","sequence":"additional","affiliation":[{"name":"Turku University Hospital","place":["Turku, Finland"]},{"name":"University of Turku","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1862-8133","authenticated-orcid":false,"given":"Tuija","family":"Vasankari","sequence":"additional","affiliation":[{"name":"Turku University Hospital","place":["Turku, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7441-0278","authenticated-orcid":false,"given":"Tuomas","family":"Paana","sequence":"additional","affiliation":[{"name":"Turku University Hospital","place":["Turku, 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