{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T04:58:02Z","timestamp":1778907482641,"version":"3.51.4"},"reference-count":18,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: high sensitive Troponin T (hsTnT) values between 14\u201350 ng\/L represent a challenge in diagnosing acute coronary syndrome (ACS) at the Emergency Department (ED). The European Society for Cardiology (ESC) recommends a second hsTnT measurement 3 h later to distinguish between ACS and other causes depending on the \u0394 hsTnT. Our study aims to evaluate the predictive power this approach in a clinical setting by following patients presenting at the ED with hsTnT values 14\u201351 ng\/L. Materials and methods: patients presenting with chest pain or dyspnea and a hsTnT value between 14 and 50 ng\/L at the Erasmus MC ED in 2012\u20132013 were included and retrospectively monitored for 90 days after initial presentation for the occurrence of a cardiac revascularization. Patient records were reviewed according to the standing protocol, which depended on the \u0394 hsTnT. The \u201cevent-group\u201d consists of patients receiving cardiac revascularization within 90 days after the ED visit, whereas the \u201cno event-group\u201d consisted of patients without revascularization. Results: a total of 889 patients patient records were reviewed. After excluding out-of-hospital-cardia-arrests (60), non-cardiological chest pain (373) and incomplete follow-up (100), 356 patients remained for final analysis. In 207 patients, a second hsTnT was actually performed (58%). From these 207 patients, 68 (33%) had a \u0394 hsTnT \u22657 ng\/L. In these patients, 37 (54%) experienced an event within 90 days. In the 139 patients with a \u0394 hsTnT &lt; 7 ng\/L, 23 (17%) presented with an event within 90 days. Conclusion: our study demonstrated a sensitivity of 62%, a specificity of 79%, a positive predicted value (PPV) of 54% and a negative predictive value (NPV) of 83% for using a 3-h \u0394 hsTnT \u22657 ng\/L cut-off, related to risk of an event in 90 days following ED presentation.<\/jats:p>","DOI":"10.3390\/jcm11237147","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T03:03:41Z","timestamp":1669863821000},"page":"7147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Predictive Power of the 14\u201351 Ng\/L High Sensitive Troponin T (hsTnT) Values for Predicting Cardiac Revascularization in a Clinical Setting"],"prefix":"10.3390","volume":"11","author":[{"given":"Frank W.","family":"De Jongh","sequence":"first","affiliation":[{"name":"Department of Clinical Chemistry, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Cardiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Cardiothoracic Surgery, HAGA Hospital, 2545 AA The Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6390-7692","authenticated-orcid":false,"given":"Sjaak","family":"Pouwels","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, 5011 GB Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjolein C.","family":"De Jongh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, HAGA Hospital, 2545 AA The Hague, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A.","family":"Dubois","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Cardiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron H. N.","family":"van Schaik","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 Esc Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with St-Segment Elevation: The Task Force for the Management of Acute Myocardial Infarction in Patients Presenting with St-Segment Elevation of the European Society of Cardiology (Esc)","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur. 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Diagnostics Guidance., Available online: www.nice.org.uk\/guidance\/dg40."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/23\/7147\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:31:04Z","timestamp":1760146264000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/23\/7147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,1]]},"references-count":18,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jcm11237147"],"URL":"https:\/\/doi.org\/10.3390\/jcm11237147","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,1]]}}}