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Circulating Macrotroponin Complexes and Their Impact on Cardiac Troponin Measurements: Potential Implications for Cardio-Oncology.
JACC CardioOncol
August 2024
Department of Medicine, Division of Cardiology, Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Long term false positive hsTnI on Alinity I probably caused by macrotroponin complex: Case report.
Clin Biochem
October 2024
Catholic University of Croatia, Zagreb, Croatia; Department of Cardiology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
Elevated troponin levels are often indicative of various cardiac diseases; however, analytical interference can lead to false positive troponin concentrations. We present the case of a 48-year-old female patient with persistently falsely elevated high sensitivity troponin I (hsTnI) probably caused by the presence of macrotroponin. Laboratory testing included determination of hsTnI using various analytical methods, serial dilutions and determination of heterophilic antibodies and other autoimmune antibodies.
View Article and Find Full Text PDF[False positive on macrotroponin].
Rev Med Suisse
July 2024
Service de médecine de laboratoire, Hôpitaux universitaires de Genève, 1211 Genève 14.
The determination of I and T subunits of cardiac troponin isoforms are the biochemical gold standard for the detection of myocardial distress. The advent of so-called highly sensitive measurements has optimized the diagnosis of acute coronary syndromes at the cost of making the diagnostic approach more complex and increasing sensitivity to analytical interference. This article presents a case of macrotroponinemia, characterized by circulating IgG-troponin T immunocomplexes, in order to raise prescribers' awareness of the critical interpretation of high and persistent cardiac troponin values.
View Article and Find Full Text PDFCardiac troponin is extensively used as a biomarker in modern medicine due to its diagnostic capability for myocardial injury, as well as its predictive and prognostic value for cardiac diseases. However, heterophile antibodies, antitroponin antibodies, and macrotroponin complexes can be observed both in seemingly healthy individuals and patients with cardiac diseases, potentially leading to false positive or disproportionate elevation of cTn (cardiac troponin) assay results and introducing discrepancies in clinical interpretations with impact on medical management. In this review article, we describe the possible mechanisms of cTn release and the sources of variations in the assessment of circulating cTn levels.
View Article and Find Full Text PDFPractical approaches to the detection of macrotroponin.
Ann Clin Biochem
March 2024
Chemical Pathology, LabPlus, Auckland City Hospital, Auckland, New Zealand.
Introduction: Macrotroponin is increasingly recognised as a cause of confusion in interpreting high-sensitivity cardiac troponin (hs-cTnI) results. In this study, we sought to evaluate two practical approaches to detecting macrotroponin. These two approaches are PEG precipitation and SVM (support vector machine) analysis to classify discrepancies between hs-cTn assays.
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