Pre-analytical interference in point-of-care troponin T testing: a case series
Lekha Priyadharshini Kamarajan1, Priyanshu Tripathi1, Sushil Kumar1
1Department of Biochemistry, All India Institute of Medical Science Patna, Patna, India.
Diagnosis (Berlin, Germany)
|September 1, 2025
Summary
Severe blood abnormalities can cause point-of-care troponin T (POCT) testing failures in suspected acute coronary syndrome (ACS) patients. Normalizing these factors allows for successful POCT, highlighting the need for pre-testing screening.
Area of Science:
- Clinical Chemistry
- Cardiology
- Point-of-Care Testing
Background:
- Point-of-care testing (POCT) is crucial for rapid diagnosis of acute coronary syndrome (ACS).
- Troponin T testing is a key biomarker for myocardial infarction.
- POCT reliability can be affected by various pre-analytical factors.
Observation:
- Five patients with suspected ACS experienced failed Roche Troponin T Card Tests despite correct procedures.
- Laboratory analysis revealed significant haematological (anaemia, polycythaemia, leucocytosis, thrombocytopenia) and biochemical (hepatic, renal) abnormalities.
- Repeat POCT after patient stabilization and parameter normalization yielded valid results.
Findings:
- Extreme haematocrit, leucocytosis, and biochemical derangements are identified as causes of POCT failure.
- Successful POCT results correlated with normalized haematological parameters in survivors.
- Pre-analytical variables significantly impact the accuracy and reliability of POCT.
Implications:
- Implementing pre-testing screening for haematological and biochemical abnormalities is essential.
- Updating guidelines for POCT utilization in acute care settings is recommended.
- Enhanced understanding of POCT limitations can improve diagnostic accuracy and patient management in ACS.
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