Influence of Macrotroponin on the 99th Percentile Threshold in 2 High-Sensitivity Cardiac Troponin Assays.
Background Cardiac troponin (cTn) levels exceeding the 99th percentile upper reference limit and a rise/fall pattern are key for diagnosing myocardial injury and infarction. Macrotroponins, formed by patient anti-cTn antibodies targeting cTn, can cause persistently elevated cTn levels without ongoin...
| Publicado en: | Clinical Chemistry Vol. 71; no. 8; pp. 884 - 896 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Oxford University Press / USA
Aug2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187168680&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187168680 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00099147 10CS jtl: Clinical Chemistry issn: 00099147 maglogo: N pubinfo: dt: Aug2025 vid: 71 iid: 8 pid: 622 pub: Oxford University Press / USA artinfo: ui: 187168680 10.1093/clinchem/hvaf068 187168680 ppf: 884 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Influence of Macrotroponin on the 99th Percentile Threshold in 2 High-Sensitivity Cardiac Troponin Assays. aug: au: Strandkjær, Nina Hansen, Morten Bagge Afzal, Shoaib Hasselbalch, Rasmus Bo Knudsen, Sophie Sander Kristensen, Jonas Henrik Kronborg, Alexander Holst Kamstrup, Pia Rørbæk Kobylecki, Camilla Jannie Hilsted, Linda Maria Dahl, Morten Overgaard, Martin Banerjee, Aditi Ladefoged, Søren Andreas Bundgaard, Henning Jaffe, Allan S Iversen, Kasper Karmark Hammarsten, Ola affil: Department of Cardiology, Herlev Hospital, University Hospital of Copenhagen, Herlev, Denmark sug: ab: Background Cardiac troponin (cTn) levels exceeding the 99th percentile upper reference limit and a rise/fall pattern are key for diagnosing myocardial injury and infarction. Macrotroponins, formed by patient anti-cTn antibodies targeting cTn, can cause persistently elevated cTn levels without ongoing myocardial injury. The frequency and impact of macrotroponin interference on cTn 99th percentiles are unclear. This study compares sex-specific 99th percentiles for 2 cTn assays, before and after excluding macrotroponin-positive samples, focusing on the top 10% of cTn levels. Methods We examined 1058 plasma samples from healthy individuals previously used for Danish cTn 99th percentiles. Following International Federation of Clinical Chemistry and Laboratory Medicine educational recommendations, macrotroponin presence was assessed in the top 10% cTn samples using immunoglobulin G (IgG) depletion screening and a reference sucrose gradient, confirming macrotroponin when both methods concurred. Due to analytical dilution constraints, [the highest] 88 of 135 Siemens Atellica high-sensitivity cTnI (hs-cTnI) samples were analyzed with both methods. All 106 Roche hs-cTnT samples were negative using IgG depletion, and sucrose analysis was limited to the highest 70 samples. Results Macrotroponin was found in 76% (67/88) of Siemens samples but in none of the Roche samples (0/70). Excluding macrotroponin-affected samples lowered the Siemens 99th percentiles from 117 ng/L to 22 ng/L in men and from 37 ng/L to 9 ng/L in women. The 99th/50th percentile ratio for Siemens decreased from 12- to 29-fold to 3- to 7-fold, approaching the Roche ratios. Conclusions Macrotroponin significantly influenced the Siemens Atellica hs-cTnI 99th percentiles, suggesting important clinical implications that warrant further prospective studies. The 99th/50th percentile ratio may help evaluate macrotroponin interference in troponin assays. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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