A false-positive troponin should be suspected when the cTn elevation does not fit the rise and fall pattern classically observed in cases of acute myonecrosis, especially if the patient's clinical presentation does not suggest an ACS.
If a false-positive cTn is suspected, it si recommended that the cTn assay be repeated with the techniques used to determine whether there is heterophile antibody interference.
Practice points:-
- Tachycardia, myocarditis, and other conditions that lead to myonecrosis are common causes of elevated cTn levels.
- Patients with a myocardial infarction and myonecrotic conditions have fluctuating cTn levels; suspect analytical interference in patients with consistently elevated cTn levels.
- Perform a stress test and enzyme assays to confirm suspected analytical interference.
- Heterophile blocking antibodies can cause falsepositive troponin levels, and adding them to the reagent in confirmed cases of analytical interference may decrease cTn levels
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