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December 8, 2025European Heart JournalOpen Access

Long forms of cardiac troponin T for myocardial infarction diagnosis: the SuperTROPO study

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Key result

Long cTnT improves MI discrimination over standard total cTnT, raising AUC to 0.83 vs 0.78.

  • AUC 0.833
  • 95% CI 0.804-0.863
  • P<.001
  • n=1,811

Why the study?

Does measuring long cTnT improve the identification of myocardial infarction compared to total cTnT in emergency department patients with elevated total cTnT levels?

Population

1,811 consecutive emergency department patients with standard high-sensitivity cardiac troponin T levels…

Comparison

Measurement of intact and minimally fragmented… vs Standard high-sensitivity cTnT measurement

Design

Cohort

Authors

JAJuhani AiraksinenElectrophysiologyHPHanna‐Mari PallariGeneral CardiologyTPTuomas PaanaTurku University Hospital

Discussion

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Implication

Measuring long forms of cardiac troponin T provides superior discriminative ability for diagnosing myocardial infarction compared to standard total cTnT assays in patients with elevated troponin levels.

Key Points

  • The research aims to evaluate the diagnostic utility of long cardiac troponin T for identifying myocardial infarction.
  • Measured long cTnT levels using a novel immunoassay in emergency department patients with elevated total cTnT levels.
  • Assessed patients with type 1 myocardial infarction and overall myocardial infarction cases.
  • Utilized area under curve analysis to compare long cTnT's performance against total cTnT.
  • Out of 1811 patients, 205 had myocardial infarction, with long cTnT showing superior diagnostic capability.
  • The area under curve for long cTnT was 0.833 for any MI and 0.839 for type 1 MI, significantly better than total cTnT.
  • Integration of long cTnT with total cTnT improved reclassification and decision-making in diagnosing MI.

Study Design

Type

Observational (n=1,811)

Structured PICO

Does measuring long cTnT improve the identification of myocardial infarction compared to total cTnT in emergency department patients with elevated total cTnT levels?

P
Population
1,811 consecutive emergency department patients with elevated high-sensitivity cTnT levels (≥14 ng/L) evaluated for myocardial infarction.
E
Exposure
Measurement of intact and minimally fragmented cTnT (long cTnT) using a novel immunoassay
C
Comparator
Standard high-sensitivity cTnT (total cTnT) measurement (Roche Diagnostics)
O
Outcome
Identification of type 1 myocardial infarction or any myocardial infarctionsurrogate

Main Result

Effect estimate: AUC 0.833 (95% CI 0.804-0.863)

Absolute Event Rate: 0.833% vs 0.782%

p-value: p=<.001

Measuring long forms of cardiac troponin T provides superior discriminative ability for diagnosing myocardial infarction compared to standard total cTnT assays in patients with elevated troponin levels.

Cite This Study

Airaksinen et al. (2025) conducted an observational in Elevated cardiac troponin levels / suspected myocardial infarction (n=1,811). Long cTnT assay vs. Total cTnT assay was evaluated on Identification of any myocardial infarction (AUC 0.833, 95% CI 0.804-0.863, p=<.001). Measuring long cTnT demonstrated superior discriminative ability compared to total cTnT for identifying any myocardial infarction (AUC 0.833 vs 0.782; P<0.001).

synapsesocial.com/papers/693624984fa91c937236bffdhttps://doi.org/10.1093/eurheartj/ehaf975
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Time-Dependent Degradation Pattern of Cardiac Troponin T Following Myocardial Infarction2013 · 104 citations
  2. 2Cardiac troponin elevations in marathon runners. Role of coronary atherosclerosis and skeletal muscle injury. The MaraCat Study2019 · 48 citations
  3. 3Long cardiac troponin T forms in a healthy reference population2025 · 6 citations
  4. 4Characterization of Cardiac Troponin Fragment Composition Reveals Potential for Differentiating Etiologies of Myocardial Injury2024 · 20 citations
  5. 5Design and Analytical Evaluation of Novel Cardiac Troponin Assays Targeting Multiple Forms of the Cardiac Troponin I–Cardiac Troponin T–Troponin C Complex and Fragmentation Forms2024 · 19 citations