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Macrotroponins cause discrepancy in high-sensitivity examination.

Pavel Broz1,2, Jaroslav Racek1,3, Pavel Prokop1

  • 1Institute of Clinical Biochemistry and Haematology, University Hospital in Pilsen, Pilsen, Czech Republic.

Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
|January 11, 2023
PubMed
Summary

Macro-troponin interference can cause misleading cardiac biomarker results. This study demonstrates how laboratory analysis, including gel filtration, can identify macro-troponin to prevent unnecessary patient investigations.

Keywords:
cardiac troponinimmunoassayinterferencemacrotroponin

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Area of Science:

  • Clinical Chemistry
  • Biomarker Analysis
  • Immunochemistry

Background:

  • Cardiac troponins (cTnI and cTnT) are critical biomarkers for diagnosing myocardial infarction.
  • Discrepancies between clinical findings and troponin levels necessitate further investigation.

Observation:

  • Two cases presented with significantly elevated cardiac troponin I (cTnI) and normal cardiac troponin T (cTnT) concentrations, conflicting with clinical presentation.
  • Initial assays suggested macro-troponin I as a potential cause for the discrepant results.

Findings:

  • Laboratory analysis, including polyethylene glycol precipitation and Sephadex G-100 gel filtration, confirmed the presence of macro-troponin I in both cases.
  • Macro-troponin I significantly interfered with cTnI assays, leading to falsely elevated results.

Implications:

  • Recognition of macro-troponin interference is crucial to avoid misdiagnosis and unnecessary patient management.
  • Close collaboration between clinicians and laboratory staff is essential for accurate interpretation of complex biomarker results.