{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:10:05Z","timestamp":1788844205037,"version":"build-2803163510"},"reference-count":19,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009687","name":"Wroclaw Medical University","doi-asserted-by":"crossref","award":["SUBZ.A460.26.068"],"award-info":[{"award-number":["SUBZ.A460.26.068"]}],"id":[{"id":"10.13039\/501100009687","id-type":"DOI","asserted-by":"crossref"}]},{"award":["SUBZ.A460.26.068"],"award-info":[{"award-number":["SUBZ.A460.26.068"]}],"id":[{"id":"https:\/\/ror.org\/01qpw1b93","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: High-sensitivity cardiac troponin I (hs-cTnI) has shown inconsistent diagnostic performance for acute cellular rejection (ACR) after heart transplantation. We evaluated whether time-normalized hs-cTnI kinetics provide incremental diagnostic value beyond the concurrent concentration for detecting ACR grade \u2265 2R and whether this association varies with time after transplantation. Methods: This retrospective single-center study included 1237 biopsy episodes from 139 heart transplant recipients. Two generalized linear mixed-effects logistic regression models with patient-specific random intercepts were compared. M1 included concurrent log2-transformed hs-cTnI, whereas M2 additionally included the time-normalized change in log2-transformed hs-cTnI per 7 days. Discrimination was assessed using leave-one-patient-out cross-validation with patient-level cluster bootstrap confidence intervals. Exploratory analyses examined early (\u226490 days), late (&gt;90 days), and continuous post-transplant time. Results: In the overall cohort, M1 showed modest discrimination (AUC 0.641, 95% CI 0.592\u20130.689), whereas M2 provided no improvement (AUC 0.635; \u0394AUC \u22120.007). Within 90 days, neither model was informative (M1 AUC 0.503; M2 AUC 0.494). Beyond 90 days, M1 showed moderate discrimination (AUC 0.758, 95% CI 0.664\u20130.838), but M2 again provided no improvement (AUC 0.746; \u0394AUC \u22120.012). Continuous-time modeling showed that the association between concurrent hs-cTnI and ACR strengthened with increasing time after transplantation, whereas the kinetic term remained non-informative. Conclusions: Time-normalized hs-cTnI kinetics did not provide incremental diagnostic value beyond concurrent hs-cTnI. Concurrent hs-cTnI may warrant further evaluation as an adjunctive late-period marker, but the 90-day threshold remains exploratory and requires external validation. Neither hs-cTnI concentration nor its kinetics should replace endomyocardial biopsy.<\/jats:p>","DOI":"10.3390\/jcm15166444","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:48:31Z","timestamp":1787219311000},"page":"6444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serial Cardiac Troponin I Kinetics Do Not Improve Detection of Acute Cellular Rejection Beyond Concurrent Troponin Levels After Heart Transplantation"],"prefix":"10.3390","volume":"15","author":[{"given":"Micha\u0142","family":"Ochman","sequence":"first","affiliation":[{"name":"Student Scientific Club of Transplantology and Advanced Therapies of Heart Failure, Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Bilnik","sequence":"additional","affiliation":[{"name":"Student Scientific Club of Transplantology and Advanced Therapies of Heart Failure, Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-6658","authenticated-orcid":false,"given":"Magdalena","family":"Cielecka","sequence":"additional","affiliation":[{"name":"Institute of Heart Diseases, Jan Mikulicz-Radecki University Hospital, 50-556 Wroclaw, Poland"},{"name":"Clinical Department of Heart Transplantation and Mechanical Circulatory Support, Department of Cardiac Surgery and Heart Transplantation, Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5730-019X","authenticated-orcid":false,"given":"Micha\u0142","family":"Zakliczy\u0144ski","sequence":"additional","affiliation":[{"name":"Institute of Heart Diseases, Jan Mikulicz-Radecki University Hospital, 50-556 Wroclaw, Poland"},{"name":"Clinical Department of Heart Transplantation and Mechanical Circulatory Support, Department of Cardiac Surgery and Heart Transplantation, Institute of Heart Diseases, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Gemelli, M., Doulamis, I.P., Tzani, A., Rempakos, A., Kampaktsis, P., Alvarez, P., Guariento, A., Xanthopoulos, A., Giamouzis, G., and Spiliopoulos, K. 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