{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T02:54:48Z","timestamp":1789872888587,"version":"4.0.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T00:00:00Z","timestamp":1588550400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Troponin is a crucial biomarker for the diagnosis of an acute coronary syndrome (ACS). It rises in response to myocardial injury from significant acute myocardial ischaemia caused by obstructive coronary artery disease [\u2018classical\u2019 myocardial infarction (MI)]. However, raised levels have also been noted in conditions not recognized as classical ACS. This may include MI with non-obstructed coronary arteries such as takotsubo cardiomyopathy and other acute or chronic conditions such as pulmonary embolus or chronic kidney disease. This is commonly labelled as a \u2018falsely elevated\u2019 troponin although there is some myocardial strain to explain the rise, such as an increase in cardiac oxygen demand. True \u2018falsely elevated\u2019 troponin, characterized by a persistent elevation in the absence of cardiac injury does occur and thought to be secondary to an immunoglobulin-troponin complex (macrotroponin).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 53-year-old gentleman with a background of diabetes, hypertension, hypercholesterolaemia, and hepatitis B was admitted with chest pain and persistently elevated cardiac troponin T (cTnT) levels. Investigations revealed unobstructed coronary arteries and a structurally normal, well-functioning heart. Subsequent biochemical analysis found the persistently elevated cTnT secondary to macrotroponin T.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Macrotroponin, an immunoglobulin-troponin bound complex should be considered as a differential diagnosis when the biochemistry is not reflective of the clinical picture. Early recognition requires effective collaboration with the biochemistry laboratory for accurate diagnosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa082","type":"journal-article","created":{"date-parts":[[2020,5,3]],"date-time":"2020-05-03T20:48:34Z","timestamp":1588538914000},"page":"1-5","source":"Crossref","is-referenced-by-count":21,"title":["False-positive troponin elevation due to an immunoglobulin-G-cardiac troponin T complex: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9365-8826","authenticated-orcid":false,"given":"Zaki","family":"Akhtar","sequence":"first","affiliation":[{"name":"Department of Cardiology, St George\u2019s University Hospital, Blackshaw Road, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Dargan","sequence":"first","affiliation":[{"name":"Department of Cardiology, St George\u2019s University Hospital, Blackshaw Road, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0544-2356","authenticated-orcid":false,"given":"David","family":"Gaze","sequence":"first","affiliation":[{"name":"Department of Cardiology, St George\u2019s University Hospital, Blackshaw Road, London SW17 0QT, UK"},{"name":"School of Life Sciences, University of Westminster, Cavendish Street, London W1W 6UW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Firoozi","sequence":"first","affiliation":[{"name":"Department of Cardiology, St George\u2019s University Hospital, Blackshaw Road, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7000-5996","authenticated-orcid":false,"given":"Paul","family":"Collinson","sequence":"first","affiliation":[{"name":"Department of Cardiology, St George\u2019s University Hospital, Blackshaw Road, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8293-7600","authenticated-orcid":false,"given":"Nesan","family":"Shanmugam","sequence":"first","affiliation":[{"name":"Department of Cardiology, St George\u2019s University Hospital, Blackshaw Road, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,3]]},"reference":[{"key":"2020062620243656000_ytaa082-B1","first-page":"1383","article-title":"Fourth universal definition of myocardial infarction (2018)","author":"Thygesen","year":"2019","journal-title":"Eur Heart J"},{"key":"2020062620243656000_ytaa082-B2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2018.09.082","article-title":"Cardiac troponin elevation in patients without a specific diagnosis","volume":"73","author":"Eggers","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2020062620243656000_ytaa082-B3","first-page":"bcr2014203729","article-title":"A non-ischaemic cause of elevated troponin; BMJ.","volume":"2014","author":"Lefort","year":"2014","journal-title":"Case Rep"},{"key":"2020062620243656000_ytaa082-B4","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1136\/heartjnl-2014-307122","article-title":"Type 2 myocardial infarction: the chimaera of cardiology?","volume":"101","author":"Collinson","year":"2015","journal-title":"Heart"},{"key":"2020062620243656000_ytaa082-B5","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1515\/CCLM.2011.147","article-title":"False positive troponin result caused by a true macrotroponin","volume":"49","author":"Michielsen","year":"2011","journal-title":"Clin Chem Lab Med"},{"key":"2020062620243656000_ytaa082-B6","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1373\/clinchem.2009.125781","article-title":"Prevalence of autoantibodies to cardiac troponin T in healthy blood donors","volume":"55","author":"Adamczyk","year":"2009","journal-title":"Clin Chem"},{"key":"2020062620243656000_ytaa082-B7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/j.1749-6632.2009.04617.x","article-title":"Circulating cardiac Troponin-I autoantibodies in human plasma and serum","volume":"1173","author":"Adamczyk","year":"2009","journal-title":"Ann N Y Acad Sci"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/3\/1\/33434456\/ytaa082.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/3\/1\/33434456\/ytaa082.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T08:07:02Z","timestamp":1593245222000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/3\/1\/5828459"}},"subtitle":[],"editor":[{"given":"Aref Bin","family":"Abdulhak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Arvind","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Mohamed","family":"Farag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Carlos Minguito","family":"Carazo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Ross","family":"Thomson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,5,3]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,5,3]]},"published-print":{"date-parts":[[2020,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa082","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,6]]},"published":{"date-parts":[[2020,5,3]]}}}