High-Sensitivity Cardiac Troponin I and Clinical Outcomes of Major Acute Cardiac Events.

ObservationalThe journal of applied laboratory medicine· Jul 2026

High-Sensitivity Cardiac Troponin I and Clinical Outcomes of Major Acute Cardiac Events.

Michelle N Steiner, Niti B Vyas, Juan U Rojo, Muneeza Esani

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Emergency MedicineObservationalDiagnosisQ2IF 1.7

Sex-specific troponin reclassification linked to lower long-term risk of major cardiac events

High-Sensitivity Cardiac Troponin I and Clinical Outcomes of Major Acute Cardiac Events.

Michelle N Steiner … Muneeza Esani

The journal of applied laboratory medicine · Jul 2026

Background

The long-term benefit of sex-specific 99th percentile upper reference limits (upper reference limits) in conjunction with high-sensitivity cardiac troponin assays for suspected acute coronary syndrome (acute coronary syndrome) are emerging.

Methods

Whose values exceeded the sex-specific upper reference limits but remained below the conventional upper reference limits were identified and compared with non-reclassified controls.

n = 1486 emergency department (ED)

Results

reclassified patients had a lower long-term risk of major cardiac events

7.6%

Women

5.7%

Men

More results

Reclassification occurred 30% more frequently in women (7.6%, 68/893) compared to men (5.7%, 34/593) and demonstrated higher rates of major adverse cardiac events (major adverse cardiac events), coronary artery disease, and cerebrovascular disease.

Among reclassified men, myocardial infarction (myocardial infarction) was more often followed by death.

More results

Among women, reclassification was associated with myocardial infarction or death, but rarely both.

The regression model also described Class 1 obesity as protective, with a 68.2% hazard reduction vs normal weight (P < 0.001).

“

Conclusion · 1 of 2

Integration of sex-specific upper reference limits and a hs-cTnI assay identified patients at increased cardiovascular risk, yet was associated with improved long-term outcomes, suggesting potential clinical value.

Conclusion · 2 of 2

Findings also reinforce the obesity paradox, with Class 1 obesity linked to reduced major adverse cardiac events risk.

High-Sensitivity Cardiac Troponin I and Clinical Outcomes of Major Acute Cardiac Events.

High-Sensitivity Cardiac Troponin I and Clinical Outcomes of Major Acute Cardiac Events.

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