Exploring strategies to rapidly identify false positives in high-sensitivity cardiac troponin I assay: A prospective study.

Autor: Desaegher A; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France., Marin V; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France., Beauvieux MC; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France; Univ. Bordeaux, CNRS, CRMSB, UMR 5536, F-33000 Bordeaux, France., Colombiès B; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France., Lauga M; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France., Alloug S; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France., Kalkan S; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France., Castaing-Mouhica G; Cellule de Biologie Délocalisée, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France., Lacape G; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France., Rucheton B; Department of Biochemistry, Bergonié Cancer Institute, F-33000 Bordeaux, France., Doublet J; Department of Cardiology, Bordeaux University Hospital, 1 rue Jean Burguet, 33000 Bordeaux, France., Dabernat S; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France; Univ. Bordeaux, INSERM, BRIC, U1312, F-33000 Bordeaux, France., Bats ML; Department of Biochemistry, Bordeaux University Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France; Univ. Bordeaux, INSERM, BMC, U1034, F-33600 Pessac, France. Electronic address: marie-lise.bats@chu-bordeaux.fr.
Jazyk: angličtina
Zdroj: Clinica chimica acta; international journal of clinical chemistry [Clin Chim Acta] 2024 Oct 11; Vol. 565, pp. 119996. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1016/j.cca.2024.119996
Abstrakt: Background: Cardiac troponin is the pivotal biomarker of myocardial injury, playing a central role in the diagnosis of acute coronary syndrome and various clinical situations. Nevertheless, challenges arise when patients exhibit elevated cardiac troponin levels in the absence of evident cardiac origin, as evidenced by extensive cardiac exploration, which suggests the presence of an interfering factor. Despite the high performance of high-sensitive cardiac troponin immunoassays, these tests remain susceptible to interferences that may lead to false-positives.
Methods: In the period between July 2021 and July 2024, 8129 patients were hospitalized in the cardiology departments of Bordeaux University Hospital with positive results for high-sensitivity cardiac troponin I. Among them, 15 patients were suspected of having false-positive results, based on clinical and biological observations.
Results: In this subpopulation, we evaluated prospectively various techniques, including serial dilutions, antibody-binding tubes, and alternative immunoassays (for cardiac troponin I and T) with the objective of identifying any potential analytical interference in their high-sensitive cardiac troponin I measurements. Our investigations revealed that 12 out of 15 suspected cases exhibited an interference on the high-sensitive cardiac troponin I assay.
Conclusion: In conclusion, we propose an original algorithm designed to identify high-sensitive cardiac troponin I false-positives. This algorithm can help clinicians to make prompt and informed decisions about patient care, and to avoid erroneous clinical interventions that may result from such interferences.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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