Carlos Alcaraz won the Cincinnati Open on Monday after top seed Jannik Sinner retired from the final due to illness, raising concerns about the Italian’s fitness just days before he begins the defence of his US Open title.

The Spanish second seed ended the world number one’s 26-match winning streak on hard courts when Sinner, trailing 5-0 in the first set, signalled he could not continue. The match lasted only 23 minutes.

“This is not the way I want to win trophies. I just have to say sorry, I can understand how you must feel,” Alcaraz told Sinner during the trophy presentation. “You are a true champion and I am sure you will come back even stronger, as you always do.”

The victory gave Alcaraz his third Masters 1000 title of the season, after earlier wins in Monte Carlo and Rome.

Sinner, who was hoping to become the first man since Roger Federer in 2015 to defend the Cincinnati crown, looked uncomfortable from the start in the hot conditions.

“Yesterday I didn’t feel great. I thought I would improve during the night, but it got worse,” Sinner told the crowd. “I tried to come out and at least play a bit, but I couldn’t handle more. I’m very sorry.”

It remains uncertain whether the Italian will be fit to play in the revamped mixed doubles event at Flushing Meadows this week. Singles action at the US Open begins on Sunday.

Monday’s match was expected to be a preview of a possible US Open final, with Alcaraz and Sinner having met in the last two Grand Slam finals. Alcaraz won at Roland Garros in June after saving three championship points, while Sinner triumphed at Wimbledon in July.

The result extended Alcaraz’s head-to-head record over Sinner to 9–5, including a 6–2 advantage on hard courts.

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