{
  "abstract": "Background/Objectives: Cardiac troponin measurement in the emergency department frequently detects non-ischaemic myocardial injury. Although this condition accounts for most troponin elevations, its clinical management remains uncertain. This study aims to determine its prevalence and evaluate its prognostic implications at a 5-year follow-up. Methods: We conducted a retrospective cohort study of 2715 emergency department patients undergoing systematic cardiac troponin testing, excluding type 1 or 2 acute myocardial infarctions. Patients with non-ischaemic myocardial injury (n = 254, 9.4%) were compared to controls (n = 2461, 90.6%) using propensity score methods (overlap weighting and 1:1 matching). Results: Before matching, patients with non-ischaemic injury were older with higher comorbidities. After overlap weighting, the risks of all-cause mortality (hazard ratio [HR] 1.75, 95% CI 1.45–2.11; p < 0.001) and major adverse cardiovascular events (HR 1.78, 95% CI 1.49–2.13; p < 0.001) remained significantly higher in the non-ischaemic injury group over a median 5.07-year follow-up. In cause-specific Cox analysis, heart failure readmission rate was increased among survivors (HR 1.64, 95% CI 1.16–2.30; p = 0.005); however, when accounting for all-cause mortality as a competing risk, this association attenuated (subdistribution hazard ratio [sHR] 1.27, 95% CI 0.90–1.80; p = 0.168). Recurrent myocardial infarction readmissions did not differ between groups (cause-specific HR 1.61, 95% CI 0.70–3.72; p = 0.265; Fine–Gray sHR 1.26, 95% CI 0.55–2.91; p = 0.596). Conclusions: Incidental detection of non-ischaemic myocardial injury in the emergency department independently predicts a substantially poorer long-term prognosis, predominantly driven by all-cause mortality. These findings highlight the clinical importance of recognizing non-ischaemic injury as a marker of high vulnerability requiring close long-term clinical follow-up.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Joan XXIII University Hospital, 43005 Tarragona, Spain",
    "Facultat de Medicina i Ciències de la Salut, University Rovira i Virgili, 43003 Tarragona, Spain",
    "Institut de Recerca Biomèdica Catalunya Sud (IRB CatSud), 43005 Tarragona, Spain",
    "Clinical Laboratory, Catalan Institute of Health, Camp de Tarragona-Teres de l’Ebre, Joan XXIII University Hospital, 43005 Tarragona, Spain",
    "Emergency Department, Joan XXIII University Hospital, 43005 Tarragona, Spain"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Isabel Jurado-Meléndez",
      "orcid": "0009-0003-7198-3753"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Carla Durà-Roldán",
      "orcid": "0009-0007-3226-4712"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Alfredo Bardají",
      "orcid": "0000-0003-1900-6974"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Isabel Fort",
      "orcid": "0000-0002-6658-3603"
    },
    {
      "affs": [
        1,
        2,
        4
      ],
      "name": "Gilmar Pugnet"
    },
    {
      "affs": [
        2
      ],
      "name": "Joan Badía"
    },
    {
      "affs": [
        2
      ],
      "name": "María Llambrich"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "José Luis Ferreiro"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9pf3tvcsnppz3.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218312",
  "fulltext_url": null,
  "id": "9pf3tvcsnppz3",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8312",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Acute Myocardial Infarction Research"
    ]
  ],
  "openalex": "W7224008085",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-25",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/9pf3tvcsnppz3.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15218312",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8312"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Acute Myocardial Infarction Research",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Long-Term Prognosis of Non-Ischaemic Myocardial Injury in the Emergency Department: A Propensity Score-Adjusted Study",
  "title_text": "Long-Term Prognosis of Non-Ischaemic Myocardial Injury in the Emergency Department: A Propensity Score-Adjusted Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:01Z",
  "url": "https://research.draconitic.com/paper/9pf3tvcsnppz3",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}