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Papers of the Week

2020 Jun

Eur Heart J Case Rep



False-positive troponin elevation due to an immunoglobulin-G-cardiac troponin T complex: a case report.


Akhtar Z, Dargan J, Gaze D, Firoozi S, Collinson P, Shanmugam N
Eur Heart J Case Rep. 2020 Jun; 4(3):1-5.
PMID: 32617489.


Troponin is a crucial biomarker for the diagnosis of an acute coronary syndrome (ACS). It rises in response to myocardial injury from significant acute myocardial ischaemia caused by obstructive coronary artery disease ['classical' myocardial infarction (MI)]. However, raised levels have also been noted in conditions not recognized as classical ACS. This may include MI with non-obstructed coronary arteries such as takotsubo cardiomyopathy and other acute or chronic conditions such as pulmonary embolus or chronic kidney disease. This is commonly labelled as a 'falsely elevated' troponin although there is some myocardial strain to explain the rise, such as an increase in cardiac oxygen demand. True 'falsely elevated' troponin, characterized by a persistent elevation in the absence of cardiac injury does occur and thought to be secondary to an immunoglobulin-troponin complex (macrotroponin).