The underestimated issue of non-reproducible cardiac troponin I and T results: case series and systematic review of the literature

source extracted confidence: high 2026-04-09
#biomarkers #biotin #humans #myocardial-infarction #troponin-i

The underestimated issue of non-reproducible cardiac troponin I and T results: case series and systematic review of the literature

Favresse et al., 2021 | Clin Chem Lab Med | Systematic Review

Citation

Favresse Julien, Bayart Jean-Louis, ... Perrone Marco. The underestimated issue of non-reproducible cardiac troponin I and T results: case series and systematic review of the literature. Clin Chem Lab Med. 2021-Jun-25;59(7):1201-1211. doi:10.1515/cclm-2020-1564

Abstract

Cardiac troponins (cTn) are the preferred biomarkers for the evaluation of myocardial injury and play a key role in the diagnosis of acute myocardial infarction (MI). Pre-analytical or analytical issues and interferences affecting troponin T and I assays are therefore of major concern given the risk of misdiagnosis. False positive troponin results have been related to various interferences including anti-troponin antibodies, heterophilic antibodies, or elevated alkaline phosphatase level. On the other hand, false negative results have been reported in the case of a large biotin intake. These interferences are characterized with erroneous but reproducible troponin results. Of interest, non-reproducible results have also been reported in the literature. In other words, if the sample is reanalyzed a second time, a significant difference in troponin results will be observed. These interferences have been named "fliers" or "outliers". Compared to the biotin interference that received major attention in the literature, troponin outliers are also able to induce harmful clinical consequences for the patient. Moreover, the prevalence of outliers in recent studies was found to be higher (0.28-0.57%) compared to the biotin interference. The aim of this systematic review is to warn clinicians about these non-reproducible results that may alter their clinical judgment. Four case reports that occurred in the Clinique of Saint-Luc Bouge are presented to attest this point. Moreover, we aimed at identifying the nature of these non-reproducible troponin results, determining their occurrence, and describing the best way for their identification.

Key Findings

Moreover, we aimed at identifying the nature of these non-reproducible troponin results, determining their occurrence, and describing the best way for their identification.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Biomarkers
  • Biotin
  • Humans
  • Myocardial Infarction
  • Troponin I
  • Troponin T

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: biotin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09