Differences in Biomarker Concentrations in the Acute Phase of 
NSTEMI, myocardial injury
ADVERSE EVENTS, OTHER CARDIOVASCULAR DISEASE
In the acute phase, the adjusted linear model showed higher hs‐cTnT concentrations in patients with MI‐CAD compared with MINOCA, indicating a greater degree of myocardial injury in those with MI‐CAD. Indeed, numericallyNT‐proBNP concentrations in patients with MINOCA were similar to patients with MI‐CAD, except for patients with NSTEMI, in whom a more rapid decline was seen after the initial 10 to 20 hours. This corresponds with previous dataHs‐CRP concentrations were overall higher in patients with MINOCA compared with MI‐CAD. This may be attributable to a proinflammatory disposition in patients with MINOCA.GDF‐15 is a stress‐responsive member of the transforming growth factor‐β cytokine superfamily and is a well‐established marker of poor prognosis and future adverse events in patients with MI but also other cardiovascular disease.An interesting observation was that the duration from onset of symptoms to blood sampling was substantially longer for patients with MINOCA than for patients with MI‐CAD. This might depend on a longer delay for patients with MINOCA to seek medical attention or a slower response from caregivers. Such structural biases might also have been present in other studies investigating biomarker concentrations in mixed populations with MI (ie, not only consisting of patients with MINOCA or MI‐CAD but also, and more important, of patients with STEMI and NSTEMI). In the present study, patients with NSTEMI experienced a 2‐fold to 3‐fold longer time to blood sampling from the onset of symptoms. Moreover, bear in mind that patients with STEMI and NSTEMI, in addition to MINOCA and MI‐CAD, displayed rather different biomarker dynamics of hs‐cTnT, NT‐proBNP, and hs‐CRP during the first 50 hours. Accordingly, time from symptom debut to blood sampling, MINOCA/MI‐CAD status, and STEMI/NSTEMI status need to be considered when evaluating biomarker concentrations in patients with MI. Indeed, the importance of considering these 3 variables was further substantiated by the significant global tests of interaction in the spline models.