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September 14, 2026Heart Lung and CirculationOpen Access

Troponin assay interference is linked to unnecessary treatment changes in ~81% of affected patients.

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Why the study?

Up to 10% of elevated cardiac troponin immunoassay results may be falsely positive due to heterophile antibodies or macrotroponin complexes, leading to misdiagnoses.

Population

26 patients with confirmed troponin interference from 148,987 hs-cTnI requests

Design

Retrospective single-centre cohort study

Key result

Among 26 patients with confirmed troponin assay interference, 81% received unnecessary treatment changes and estimated costs averaged AUD $16,331 per patient due to avoidable admissions and procedures.

Authors

LTLung En TengPTPreetha ThomasEQE. Quine

Discussion

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Overview

Troponin interference may drive misdiagnoses and avoidable costs; observational data leaves optimal detection and mitigation strategies open.

Key Points

  • To determine the clinical misclassifications, delays in recognition, downstream management impacts, and healthcare costs associated with false-positive cardiac troponin assay interference.
  • Retrospective cohort study at the Royal Melbourne Hospital, Australia, reviewing 148,987 Abbott high-sensitivity troponin-I requests ordered between January 2021 and December 2024.
  • Interference was confirmed when secondary testing using alternative Ortho Vitros or Roche high-sensitivity troponin assays on the identical plasma sample returned negative results.
  • Among 26 patients with confirmed interference (median age 48 years; median troponin 150 ng/L), 73% underwent invasive coronary angiography or CT imaging, and over half had normal cardiac anatomy.
  • Misdiagnoses occurred in 35% for myocarditis and 23% for non-ST-elevation myocardial infarction, driving treatment alterations in 81% with a median recognition delay of 7.5 months.
  • Assay interference was recorded in only 54% of medical records and 19% of discharge summaries, generating an average healthcare cost of AUD $16,331 per patient primarily from avoidable admissions.

Study Design

Type

Cohort (n=26)

Multicenter

No

Structured PICO

P
Population
26 patients with confirmed troponin assay interference evaluated for clinical misclassification, treatment changes, and healthcare costs.
O
Outcome
Clinical characteristics, investigations, treatment, documentation, and health care costs associated with false-positive troponins

Troponin assay interference is an under-recognized cause of false-positive results that leads to significant diagnostic errors, unnecessary invasive testing, and substantial healthcare costs.

Cite This Study

Teng et al. (2026) conducted a cohort in False-positive troponins (n=26). Troponin assay interference was evaluated on Clinical misclassification, treatment changes, and health care costs. Among 26 patients with confirmed troponin assay interference, 81% received unnecessary treatment changes and estimated costs averaged AUD $16,331 per patient due to avoidable admissions and procedures.

synapsesocial.com/papers/6aa7b1e579e9260bc85aad5ehttps://doi.org/10.1016/j.hlc.2026.05.007
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1False-Positive High-Sensitivity Troponin I in Clinical Practice2026
  2. 2Falsely elevated troponin: rare occurrence or future problem2016 · 16 citations
  3. 3Multiple admissions to the coronary care unit due to falsely elevated cardiac troponin2018 · 6 citations
  4. 4UNDERSTANDING TROPONINS: HOW IMPORTANT IT IS2022 · 1 citations
  5. 5False-Positive Cardiac Troponin Elevations in Skeletal Muscle Disease: Clinical Relevance, Mechanisms, and Laboratory Approaches2025