The Trouble with Troponin

Serum Troponin is a sensitive and specific marker of heart muscle damage that is widely used in the assessment of people with chest pain. Its usefulness is, however, sometimes limited by false positive or negative results caused by proteins or fibrin in the patient's blood. More importantly, there is no agreed Troponin I standard at present which means that results from different assays cannot be directly compared. In addition, there is no consensus of the way in which serum Troponin results should be reported which means that some cut-offs minimise false positives, whilst others minimise false negatives. There is a need for cardiologists and pathologists to work together to resolve this issue.