{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:54:10Z","timestamp":1781790850999,"version":"3.54.5"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The diagnostic and prognostic roles of cardiovascular biomarkers in chronic coronary syndrome remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients undergoing coronary angiography for suspected chronic coronary syndrome were prospectively enrolled (n=2251; median follow\u2010up 12.6\u2009years). Obstructive coronary artery disease was defined as \u226550% stenosis in \u22651 major epicardial vessel. HsTnT (high\u2010sensitivity cardiac troponin T), NT\u2010proBNP (N\u2010terminal pro\u2010B\u2010type natriuretic peptide), high\u2010sensitivity C\u2010reactive protein, interleukin\u20106, and copeptin were measured. Receiver operating characteristic analysis and Cox regression with biomarker \u00d7 treatment interaction testing were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Overall, 888 patients (39.4%) had obstructive coronary artery disease. Only hsTnT showed meaningful diagnostic capacity (area under the curve 0.669; risk factor\u2010weighted clinical likelihood area under the curve 0.663), with incremental benefit inversely proportional to risk factor\u2010weighted clinical likelihood category (\u0394 area under the curve: very low 10.4%, low 8.0%, intermediate\/high 5.0%). NT\u2010proBNP was the strongest mortality predictor across optimal medical therapy (hazard ratio [HR], 1.488 [95% CI, 1.288\u20131.720],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), percutaneous coronary intervention (HR, 1.220 [95% CI, 1.020\u20131.458],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.029), and coronary artery bypass grafting (HR, 1.220 [95% CI, 1.049\u20131.420],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.010). Interaction analysis validated a data\u2010derived 150\u2009pg\/mL threshold (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.032): below it, mortality was comparably low regardless of revascularization (HR, 0.98 [95% CI, 0.67\u20131.43],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.910); above it, baseline risk was markedly elevated (HR, 5.75 [95% CI, 4.10\u20138.00],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and revascularization associated with 40% mortality reduction, with substantial residual risk (HR, 3.43 [95% CI, 2.70\u20134.40],\n                      <jats:italic toggle=\"no\">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\">HsTnT provides risk factor\u2010weighted clinical likelihood category\u2010specific incremental diagnostic value. NT\u2010proBNP is a universal prognostic marker identifying patients with distinct revascularization\u2010associated mortality reduction driven by differential baseline risk.<\/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:\/\/clinicaltrials.gov\/study\/NCT00497887\">https:\/\/clinicaltrials.gov\/study\/NCT00497887<\/jats:ext-link>\n                      ; Unique Identifier: NCT00497887.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048737","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T04:31:56Z","timestamp":1780115516000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac Biomarkers to Refine Pretest Probability for Coronary Obstruction and Predict Survival After Revascularization in Chronic Coronary Syndrome"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8587-9397","authenticated-orcid":false,"given":"Andrej","family":"Teren","sequence":"first","affiliation":[{"name":"Bielefeld University, Klinikum Bielefeld Mitte","place":["Bielefeld, Germany"]},{"name":"University of Leipzig","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0166-3936","authenticated-orcid":false,"given":"Jeffrey","family":"Netto","sequence":"additional","affiliation":[{"name":"University of Leipzig","place":["Germany"]},{"name":"Bielefeld University","place":["Bielefeld, Germany"]},{"name":"University Hospital Leipzig","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7606-1852","authenticated-orcid":false,"given":"Joachim","family":"Thiery","sequence":"additional","affiliation":[{"name":"University of Leipzig","place":["Germany"]},{"name":"University Hospital Leipzig","place":["Germany"]},{"name":"Christian\u2010Albrechts\u2010University Kiel","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-998X","authenticated-orcid":false,"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[{"name":"University of Leipzig","place":["Germany"]},{"name":"Heart Center Leipzig at Leipzig University","place":["Leipzig, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8429-2826","authenticated-orcid":false,"given":"Christoph","family":"Stellbrink","sequence":"additional","affiliation":[{"name":"Bielefeld University, Klinikum Bielefeld Mitte","place":["Bielefeld, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1292-7845","authenticated-orcid":false,"given":"Dennis","family":"Lawin","sequence":"additional","affiliation":[{"name":"Bielefeld University, Klinikum Bielefeld Mitte","place":["Bielefeld, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2930-8493","authenticated-orcid":false,"given":"Thorsten","family":"Lawrenz","sequence":"additional","affiliation":[{"name":"Bielefeld University, Klinikum Bielefeld Mitte","place":["Bielefeld, 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