Persistent Troponin Elevation: Macrotoponin and Diagnostic Pathways for the Unexplainable Positive Troponin Result

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Cardiac troponins are very sensitive biomarkers of myocardial injury and have a central role in the diagnosis of acute ischemic and inflammatory cardiac disease. It is increasingly recognized that the specificity of serum troponin assays for clinically important cardiac injury is affected by non-cardiac illnesses including sepsis and systemic inflammation, or by factors that can spuriously elevate the cardiac troponin assay. A less recognised cause of serum troponin elevation occurring in the absence of acute cardiac injury is macrotroponin.