Persistent Increases in Cardiac Troponin Concentrations As Measured with High-Sensitivity Assays after Acute Myocardial Infarction
Bibliographic record
Abstract
To the Editor: We read with interest the report by Koenig et al. (1) showing the value of high-sensitivity cardiac troponin T (hs-cTnT)1 assays for predicting long-term cardiovascular events in patients after an acute coronary syndrome (ACS) or coronary artery bypass grafting. Although studies have demonstrated long-term cardiovascular events with measurements of hs-cTnI or hs-cTnT in patients who present with symptoms suggestive of ACS (2, 3), Koenig et al. found a relationship with hs-cTnT concentrations after patients had been discharged from a cardiac rehabilitation program (mean time to discharge and hs-cTnT measurement was 43 days from the index event) (1). hs-cTnT concentrations >3 ng/L (limit of blank) remained detectable in 84% of patients and were ≥14 ng/L (99th percentile) in 37.1% of the patients. These findings raise important questions about how gradually hs-cTnT concentrations decrease in the absence of recurrent ACS and have implications regarding the use of high-sensitivity cardiac troponin assays for diagnosing subsequent events in patients who are stable after an ACS. To address these questions, we conducted a prospective observational study to assess whether cardiac troponin concentrations normalize by 30 days after an acute myocardial infarction (AMI). After obtaining ethics approval, we recruited a convenience sample of Hamilton General Hospital patients who consented to return 30 …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.003 | 0.006 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".