{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T11:28:05Z","timestamp":1793618885424,"version":"4.5.0"},"reference-count":20,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2026-0790_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Understanding whether the novel long-T ITC complex might assist in interpreting clinical prognostic utility compared to established cardiac biomarkers is needed. We determined long term major adverse cardiac events (MACE) and all-cause mortality (ACM) predicated on novel long-T ITC complex and high sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT) assays in the emergency department\u00a0(ED).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0790_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>cTn assays were measured on the Mindray CL-1200i platform at presentation in consecutive patients enrolled in \u2018Mindray hs-cTnI Assay Analytical and Clinical Evaluation for the Diagnosis and RIsk Assessment of Myocardial InfarctIon\u2019 (MERITnI) (NCT05853042) trial with suspected ischemia. Sex specific 99th percentiles upper reference limits (URLs) were: hs-cTnI female 14\u202fng\/L, male 15\u202fng\/L; hs-cTnT female 10\u202fng\/L, male 19\u202fng\/L; long-T ITC complex 0.9\u202fng\/L, same for female and\u00a0male.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0790_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1,070 patients, 59.4\u202f% were male, 43.4\u202f% White, 45.5\u202f% Black, and 39.5\u202f%\u00a0\u226565\u202fyears. Independent of biomarkers, a continuum of risk over 1\u00a0year showed MACE increased to 16.1\u202f% and ACM to 16.5\u202f%. Long-T ITC complex did not show a continuum change, increasing only 0.1\u202f% (HR: 1.001 (1.0\u20131.001) per ng\/L. However, hs-cTnI increased 1.8\u202f% (HR: 1.018 [1.009\u20131.027] for each ng\/L (p&lt;0.0001) and hs-cTnT increased 0.3\u202f% per ng\/L (HR: 1.003 [1.001\u20131.006]) (p=0.0028). Between subjects\u00a0\u2264URLs and &gt;URLs, MACE and ACM all biomarkers showed significant (p&lt;0.0001) differences over 1\u202fyear. For MACE in those &gt;URL long-T ITC complex increased 11.2\u201325.2\u202f%, hs-cTnI 18.0\u201335.0\u202f% and hs-cTnT 8.9\u201324.2\u202f%. For ACM in those &gt;URL long-T ITC complex increased 4.5\u201323.3\u202f%, hs-cTnI 5.0\u201326.2\u202f%, and hs-cTnT 3.6\u201324.1\u202f%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0790_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Novel long-T ITC complex did not provide new prognostic value to either hs-cTnI or hs-cTnT. Patients with increased hs-cTnI and hs-cTnT concentrations had marked increases in MACE and ACM risk at 1-year.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2026-0790","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T17:56:55Z","timestamp":1785088615000},"page":"2925-2932","source":"Crossref","is-referenced-by-count":0,"title":["Risk outcome assessment with novel long-T ITC complex and high sensitivity troponin I and T in patients with suspected acute coronary syndromes: MERITnI substudy"],"prefix":"10.1515","volume":"64","author":[{"given":"Fred S.","family":"Apple","sequence":"first","affiliation":[{"name":"Hennepin Healthcare Research Institute , Minneapolis , MN , USA"},{"name":"Department of Laboratory Medicine & Pathology , Hennepin Healthcare , Minneapolis , MN , USA"},{"name":"Department of Laboratory Medicine & Pathology , University of Minnesota School of Medicine , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G.","family":"Buda","sequence":"additional","affiliation":[{"name":"Division of Pulmonary & Critical Care Medicine , Mayo Clinic , Rochester , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barret P.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine , Hennepin Healthcare , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yader","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Allina Health Minneapolis Heart Institute , Abbott Northwestern Hospital , Minneapolis , MN , USA"},{"name":"Center for Coronary Artery Disease , Minneapolis Heart Institute Foundation , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine , Hennepin Healthcare , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah M.","family":"Brown","sequence":"additional","affiliation":[{"name":"Hennepin Healthcare Research Institute , Minneapolis , MN , USA"},{"name":"Department of Laboratory Medicine & Pathology , Hennepin Healthcare , Minneapolis , MN , USA"},{"name":"Department of Laboratory Medicine & Pathology , University of Minnesota School of Medicine , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Miller","sequence":"additional","affiliation":[{"name":"Hennepin Healthcare Research Institute , Minneapolis , MN , USA"},{"name":"Department of Laboratory Medicine & Pathology , Hennepin Healthcare , Minneapolis , MN , USA"},{"name":"Department of Laboratory Medicine & Pathology , University of Minnesota School of Medicine , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Sexter","sequence":"additional","affiliation":[{"name":"Hennepin Healthcare Research Institute , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Schulz","sequence":"additional","affiliation":[{"name":"Hennepin Healthcare Research Institute , Minneapolis , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan S.","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Departments of Cardiology and Laboratory Medicine and Pathology , Mayo Clinic , Rochester , MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026110211032901021_j_cclm-2026-0790_ref_001","doi-asserted-by":"crossref","unstructured":"Apple, FS, Buda, KG, Wagner, BP, Anne Sexter, A, Sandoval, Y, Smith, SW, et al.. 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