Bosi Davide, Canovi Simone, Pennacchioni Andrea, Demola Pierluigi, Corradini Mattia, Guiducci Vincenzo, Colla Rossana, Navazio Alessandro
Cardiology Unit, AUSL-IRCCS di Reggio Emilia, 42100 Reggio Emilia, Italy.
Clinical Laboratory Unit, AUSL-IRCCS di Reggio Emilia, 42100 Reggio Emilia, Italy.
J Cardiovasc Dev Dis. 2023 Sep 3;10(9):378. doi: 10.3390/jcdd10090378.
Cardiac troponins are key diagnostic and prognostic biomarkers in acute myocardial infarction and, more generally, for the detection of myocardial injury. Since the introduction of the first immunochemistry methods, there has been a remarkable evolution in analytical performance, especially concerning a progressive improvement in sensitivity. However, the measurement of circulating troponins remains rarely susceptible to analytical interferences. We report a case of persistently elevated troponin I concentrations in a patient with known ischemic heart disease, which almost led to unnecessary diagnostic-therapeutic interventions. A prompt laboratory consultation by the cardiologist ultimately led to the identification of an analytical interference due to troponin macrocomplexes (macrotroponin) causing elevated troponin values in the absence of a clinical presentation compatible with myocardial damage.
心肌肌钙蛋白是急性心肌梗死以及更广泛地用于检测心肌损伤的关键诊断和预后生物标志物。自首次引入免疫化学方法以来，分析性能有了显著进展，尤其是在灵敏度方面有了逐步提高。然而，循环肌钙蛋白的测量仍然很少受到分析干扰的影响。我们报告了一例已知患有缺血性心脏病患者的肌钙蛋白I浓度持续升高的病例，这几乎导致了不必要的诊断性治疗干预。心脏病专家及时进行实验室会诊，最终确定是由于肌钙蛋白大复合物（巨肌钙蛋白）引起的分析干扰，导致在没有与心肌损伤相符的临床表现情况下肌钙蛋白值升高。
