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The false positive troponin results: case studies of analytical interference

Saerrah Murryam1, Paul Cook2, Sebastien Ellis2

  • 1University Hospital Southampton NHS Foundation Trust, Southampton, UK saerrah.murryam@uhs.nhs.uk.

Clinical Medicine (London, England)
|January 26, 2022
PubMed

Insights

False positive cardiac troponin results can occur due to analytical interference in patient blood. Identifying this interference is crucial to prevent unnecessary treatments for myocardial injury.

Area of Science:

  • Cardiology
  • Clinical Chemistry
  • Biochemistry

Background:

  • Cardiac troponin I and T are sensitive biomarkers for cardiomyocyte damage, indicating myocardial injury.
  • Myocardial injury arises from oxygen supply-demand imbalance, cardiac conditions, or systemic diseases.
  • European Society of Cardiology guidelines aid in diagnosing causes of elevated troponin.

Purpose of the Study:

  • To highlight the significance of false positive troponin results due to analytical interference.
  • To present cases illustrating how analytical interference can lead to erroneous troponin concentrations.
  • To emphasize the importance of identifying interference to prevent misdiagnosis and inappropriate patient management.

Main Methods:

  • Case study presentation of two patients with elevated troponin levels.
  • Investigation into potential causes of troponin elevation, including analytical interference.
  • Utilisation of the Access assay (Beckman Coulter) with a reference range of 0-18 ng/L.

Main Results:

  • Two cases of false positive cardiac troponin results were identified.
  • Analytical interference from patient blood components was determined as the cause of elevated troponin.
  • The false positive results mimicked true myocardial injury but were not indicative of actual cardiomyocyte damage.

Conclusions:

  • Analytical interference is an under-recognized cause of elevated cardiac troponin.
  • Accurate diagnosis requires considering and investigating potential false positive results.
  • Identifying analytical interference is critical for appropriate patient care, avoiding unnecessary interventions.

Keywords:
analytical interferenceheterophile antibodytroponin

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