The false positive troponin results: case studies of analytical interference

Murryam, Saerrah; Cook, Paul; Ellis, Sebastien

doi:10.7861/clinmed.2021-0633

Cited by 3 publications

(1 citation statement)

References 3 publications

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“…Research suggests that troponin alone lacks high specificity for diagnosing heart disease. For instance, Yen et al 33 34 found that children with supraventricular tachycardia (SVT) who tested positive for troponin I exhibited clinical symptoms similar to those with normal troponin I levels. Consequently, their findings highlight the limited predictive value of troponin I for SVT recurrence.…”

Section: Discussionmentioning

confidence: 99%

Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study

Wu,

Ji,

Huang

et al. 2023

BMJ Open

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IntroductionPaediatric myocarditis, a rare inflammatory disease, often presents without clear early symptoms. Although cardiac troponin I levels can aid in diagnosing myocarditis, they are not definitive indicators. Troponin I levels frequently fluctuate within and outside the reference range, potentially causing misinterpretations by clinicians. Although a negative troponin I result is valuable for excluding myocarditis, its specificity is low. Moreover, the clinical diagnosis of paediatric myocarditis is exceptionally challenging, and accurate early-stage diagnosis and treatment pose difficulties. Currently, the Dallas criteria, involving cardiac biopsy, serves as the gold standard for myocarditis diagnosis. However, this method has several drawbacks and is unsuitable for children, resulting in its limited use.Methods and analysisIn this study, we will employ multiple logistic regression analysis to develop a predictive model for early childhood myocarditis. This model will assess the patient’s condition at onset and provide the probability of a myocarditis diagnosis. Model performance will be evaluated for accuracy and calibration, and the results will be presented through receiver operating characteristic (ROC) curves and calibration plots. Clinical decision curve analysis, in conjunction with ROC curve analysis, will be employed to determine the optimal cut-off value and calculate the net clinical benefit value for assessing clinical effectiveness. Finally, internal model validation will be conducted using bootstrapping.Ethics and disseminationApproval from the Clinical Research Ethics Committee of The Third Affiliated Hospital of Wenzhou Medical University has been obtained. The research findings will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals.

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Section: Discussionmentioning

confidence: 99%

Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study

Wu,

Ji,

Huang

et al. 2023

BMJ Open

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Assay interference as a cause of false positive troponin T elevation in emergency department patients

Lyons

Herity

Lee

et al. 2023

International Journal of Cardiology

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False Elevation of Troponin Levels in a Patient With Chest Pain and Significant Psychoemotional Stress

Elkhedr,

Elkhidir

2023

Cureus

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We present a case of a 63-year-old woman who experienced significant psychoemotional stress and was seen in the emergency department for an evaluation of chest pain. She was sent home after reassurance. Subsequent troponin levels came back above the normal range. The patient was called back to the hospital for further assessment, including a potential workup for the exclusion of acute coronary syndrome, given the existing risk factors, symptoms, and elevated cardiac enzymes. The patient has risk factors for atherosclerosis, including hypercholesterolemia, hypertension, and age. She has recently gone through hard personal, emotional, and psychosocial stress. She presented with atypical chest pain, subjective sense of breathlessness, and anxiety. She was reassured, had blood tests ordered, and was discharged after relative improvement. Later that day, her blood test results, which were taken earlier, showed elevated troponin levels. Therefore, she was asked to come back for a cardiology assessment and underwent coronary angiography, which showed normal patent coronary arteries. This case report highlights a patient with a non-cardiac elevation of troponin, emphasizing the importance of considering non-cardiac causes when interpreting elevated troponin levels. The objective of this report is to raise awareness among healthcare professionals regarding the potential causes of false troponin elevation and promote a comprehensive diagnostic approach to minimize unnecessary interventions.

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The false positive troponin results: case studies of analytical interference

Cited by 3 publications

References 3 publications

Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study

Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study

Assay interference as a cause of false positive troponin T elevation in emergency department patients

False Elevation of Troponin Levels in a Patient With Chest Pain and Significant Psychoemotional Stress

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