{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T10:44:01Z","timestamp":1762080241623,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"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>Many patients with peripheral arterial disease (PAD) exhibit undiagnosed obstructive coronary artery disease. We aim to identify the patients with lifestyle limiting claudication due to PAD and without cardiac symptoms, requiring coronary revascularization based on high-sensitive troponin T (hsTnT) values. We assessed hsTnT in consecutive patients referred for elective endovascular treatment due to claudication [Rutherford categories (RC) 2 &amp; 3] between January 2018 and December 2021. Diagnostic work-up by non-invasive imaging and, if required, cardiac catheterization was performed according to clinical data, ECG findings and baseline hsTnT. The occurrence of cardiac death, myocardial infarction or urgent revascularization during follow-up was the primary endpoint. Of 346 patients, 14 (4.0%) exhibited elevated hsTnT \u2265 14 ng\/L, including 7 (2.0%) with acute myocardial injury by serial hsTnT sampling. Coronary revascularization by percutaneous coronary intervention was necessary in 6 of 332 (1.5%) patients with normal versus nine of 14 (64.3%) patients with elevated hsTnT (p &lt; 0.001). During 2.4 \u00b1 1.4 years of follow-up, 20 of 286 (7.0%) patients with normal versus four of 13 (30.8%) with elevated hsTnT at baseline reached the composite primary endpoint (p = 0.03 by log-rank test). In conclusion, elevated troponins in cardiac asymptomatic patients with claudication modify subsequent cardiac management and may increase the need for closer surveillance and more aggressive conservative management in polyvascular disease.<\/jats:p>","DOI":"10.3390\/jcm11247287","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T03:23:49Z","timestamp":1670556229000},"page":"7287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cardiac Troponins for the Clinical Management of Patients with Claudication and without Cardiac Symptoms"],"prefix":"10.3390","volume":"11","author":[{"given":"Dimitrios","family":"Mouselimis","sequence":"first","affiliation":[{"name":"Cardiology, Vascular Medicine & Pneumology, GRN Hospital Weinheim, Roentgentrasse 1, 69469 Weinheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saskia","family":"Hagstotz","sequence":"additional","affiliation":[{"name":"Cardiology, Vascular Medicine & Pneumology, GRN Hospital Weinheim, Roentgentrasse 1, 69469 Weinheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Lichtenberg","sequence":"additional","affiliation":[{"name":"Vascular Center Klinikum Arnsberg, 59821 Arnsberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos P.","family":"Donas","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery, Asclepios Clinic Langen, 63225 Langen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Heinrich","sequence":"additional","affiliation":[{"name":"Practice for Vascular Medicine and Gastroenterology, 69469 Weinheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Avranas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asclepios Clinic Langen, 63225 Langen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zisis","family":"Dimitriadis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Frankfurt, 60590 Frankfurt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erwin","family":"Blessing","sequence":"additional","affiliation":[{"name":"SRH Hospital, Department of Internal Medicine, 76307 Karlsbad, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0455-5081","authenticated-orcid":false,"given":"Ralf","family":"Langhoff","sequence":"additional","affiliation":[{"name":"Department of Angiology, Sankt-Gertrauden-Krankenhaus, 10713 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Cardiology, Angiology & Pneumology, University Hospital Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo A.","family":"Katus","sequence":"additional","affiliation":[{"name":"Cardiology, Angiology & Pneumology, University Hospital Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6038-2253","authenticated-orcid":false,"given":"Grigorios","family":"Korosoglou","sequence":"additional","affiliation":[{"name":"Cardiology, Vascular Medicine & Pneumology, GRN Hospital Weinheim, Roentgentrasse 1, 69469 Weinheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1093\/eurheartj\/ehu071","article-title":"Non-Coronary Atherosclerosis","volume":"35","author":"Gallino","year":"2014","journal-title":"Eur. 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