{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:05:25Z","timestamp":1777899925912,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T00:00:00Z","timestamp":1520380800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scott Med J"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:p>High-sensitivity cardiac troponin assays have emerged as a powerful tool in the management of patients presenting acutely to hospital with suspected cardiac chest pain. Recent guidelines emphasize the reassurance offered by low troponin concentrations early after admission. We describe a patient with known coronary artery disease, who presented with a classical history of recurrent myocardial ischaemia. High-sensitivity cardiac Troponin-I concentrations remained in the low-normal sex-specific reference range, despite serial testing on the day of admission, and despite recurrent pain with dynamic ECG changes. Urgent coronary angiography confirmed severe multi-vessel disease. He required an intra-aortic balloon pump within 24\u2009h due to clinical instability, and had urgent coronary artery bypass surgery a few days later. This case confirms that \u201cunstable angina\u201d remains a genuine entity. It highlights the hazards of over-reliance on any single test and serves as a reminder of the importance of integrating tests with clinical assessment.<\/jats:p>","DOI":"10.1177\/0036933018760764","type":"journal-article","created":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T01:53:04Z","timestamp":1520473984000},"page":"51-56","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unstable angina in the era of high-sensitivity troponin testing: a genuine entity and a cautionary tale"],"prefix":"10.1177","volume":"63","author":[{"given":"Thomas","family":"Krysztofiak","sequence":"first","affiliation":[{"name":"Consultant Cardiologist, Queen Elizabeth University Hospital, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Byrne","sequence":"additional","affiliation":[{"name":"Consultant Cardiologist, Queen Elizabeth University Hospital, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,3,7]]},"reference":[{"key":"bibr1-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2016.254730"},{"key":"bibr2-0036933018760764","unstructured":"NICE. Chest pain of recent onset: assessment and diagnosis (CG95) London: National Institute for Health and Care Excellence(updated 2016), www.nice.org.uk\/guidance\/cg95 (2016, accessed 7 January 2018)."},{"key":"bibr3-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv320"},{"key":"bibr4-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.09.171"},{"key":"bibr5-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.964791"},{"key":"bibr6-0036933018760764","unstructured":"Kapoor S, Zeserson E, et\u00a0al. Current ED management of non-st segment elevation MI (NSTEMI): a practice update. Updated 2017, www.globalintensivecare.org\/index.php\/current-ed-management-of-non-st-segment-elevation-mi-nstemi-a-practice-update\/ (accessed 30 August 2017)."},{"key":"bibr7-0036933018760764","unstructured":"Backus B, Six AJ, et\u00a0al. The heart score, www.heartscore.nl\/ (accessed 30 August 2017)."},{"key":"bibr8-0036933018760764","unstructured":"NICE. Myocardial infarction (acute): early rule out using high-sensitivity troponin tests (Elecsys Troponin T high-sensitive, ARCHITECT STAT High Sensitive Troponin-I and AccuTnI+3 assays): DG15. London: National Institute for Health and Care Excellence, www.nice.org.uk\/guidance\/dg15 (2014, accessed 7 January 2018)."},{"key":"bibr9-0036933018760764","doi-asserted-by":"publisher","DOI":"10.3310\/hta19960"},{"key":"bibr10-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-309270"},{"key":"bibr11-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308505"},{"key":"bibr12-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.026"},{"key":"bibr13-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.0695"},{"key":"bibr14-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00391-8"},{"key":"bibr15-0036933018760764","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.025021"}],"container-title":["Scottish Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0036933018760764","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0036933018760764","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0036933018760764","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:18:32Z","timestamp":1777630712000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0036933018760764"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,7]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1177\/0036933018760764"],"URL":"https:\/\/doi.org\/10.1177\/0036933018760764","relation":{},"ISSN":["0036-9330","2045-6441"],"issn-type":[{"value":"0036-9330","type":"print"},{"value":"2045-6441","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,7]]}}}