Evidence map›Paper›PMID 40514132›Full record

ArticleJACC. Case reports2025

Defining Chronic Myocyte Injury With hs-cTnT: The Importance of Serial Measurements and the Value of hs-cTnI.

Guy Miller, Sarah Davies, James Hatherley, Angela Lambert, Hannah Fearon, Lisa Bailey, Paul Collinson, Aleem Khand

Abstract readCase Reports
In one paragraph

Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Guy MillerLiverpool University Hospital NHS Foundation Trust, Liverpool, United Kingdom.
Sarah DaviesLiverpool Clinical Laboratories, Department of Clinical Biochemistry and Metabolic Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom.
James HatherleyLiverpool University Hospital NHS Foundation Trust, Liverpool, United Kingdom; Department of Ageing and Chronic Diseases, University of Liverpool, Liverpool, United Kingdom.
Angela LambertLiverpool Clinical Laboratories, Department of Clinical Biochemistry and Metabolic Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom.
Hannah FearonLiverpool Clinical Laboratories, Department of Clinical Biochemistry and Metabolic Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom.
Lisa BaileyLiverpool Clinical Laboratories, Department of Clinical Biochemistry and Metabolic Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom.
Paul CollinsonDepartment of Biochemistry, St George's Hospital, Liverpool, United Kingdom.
Aleem KhandLiverpool University Hospital NHS Foundation Trust, Liverpool, United Kingdom; Department of Ageing and Chronic Diseases, University of Liverpool, Liverpool, United Kingdom; Liverpool Heart and Chest Hospital, Liverpool, United Kingdom. Electronic address: aleem.khand@liverpoolft.nhs.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is increasing awareness of the differing characteristics of troponin subunits. CASE SUMMARY: We present a case where an elevation of high-sensitivity troponin T (hs-cTnT) (>6× 99th percentile) beyond the single-sample rule-in threshold led to an erroneous diagnosis of acute coronary syndrome (ACS). After exhaustive biochemical tests proving chronic myocardial injury, we also determined that 4 different high sensitivity assays for troponin I revealed values well below their respective 99th percentiles. This uniquely highlights the difference in troponin subunit characteristics in chronic myocyte injury and dispels any notion that the difference relates to assay characteristics. DISCUSSION: Chronic elevations of hs-cTnT can be sufficiently large to surpass single rule-in thresholds in some ACS pathways, but this case stresses the importance of the delta value regardless of the degree of elevation of the presentation sample. In cases of diagnostic doubt for ACS, clinicians should consider measuring hs-cTnI as an alternative troponin.

Indexed as

chronic myocyte injuryhigh-sensitivity troponin subtypessuspected acute coronary syndromes

Identifiers

PMID40514132
PMCPMC12237718

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.