What to do when you question cardiac troponin values

Johannes Mair, Bertil Lindahl, Christian Müller, Evangelos Giannitsis, Kurt Huber, Martin Möckel, Mario Plebani, Kristian Thygesen, Allan S. Jaffe

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


High-sensitivity cardiac troponin assays enable cardiac troponin measurement with a high degree of analytical sensitivity and a low level of analytical imprecision at the low measuring range. One of the most important advantages of these new assays is that they allow novel, more rapid approaches for ruling in or ruling out acute myocardial infarctions. The increase in the early diagnostic sensitivity of high-sensitivity cardiac troponin assays comes at the cost of a reduced acute myocardial infarction specificity of the biomarker, because more patients with other causes of acute or chronic myocardial injury without overt myocardial ischaemia are detected than with previous cardiac troponin assays. Increased troponin concentrations that do not fit with the clinical presentation are seen in the daily routine, mainly as a result of a variety of pathologies, and if tested in the same sample, even discrepancies between high-sensitivity cardiac troponin I and troponin T test results may sometimes be found as well. In addition, analytically false-positive test results occasionally may occur since no assay is perfect. In this review, we summarise the biochemical, pathophysiological and analytical background of the work-up for such a clinical setting.

Original languageEnglish (US)
Pages (from-to)577-586
Number of pages10
JournalEuropean heart journal. Acute cardiovascular care
Issue number6
StatePublished - Sep 1 2018


  • Cardiac troponin I
  • cardiac troponin T
  • discrepancy
  • high sensitivity
  • interference
  • mismatch

ASJC Scopus subject areas

  • Medicine(all)


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