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In patients presenting with symptoms that could indicate myocarditis, elevated cTn concentrations typically mandate cardiac catheterization and heart muscle biopsy or cardiac magnetic resonance imaging (CMR). Accordingly, increased cTn levels due to macrotroponin\u00a0\u2013\u00a0a complex between patient anti-troponin autoantibodies and cTn\u00a0\u2013\u00a0could lead to unnecessary and potentially harmful interventions. In athletes, ensuring cardiac health after infection like COVID-19 is critical, but the occurrence of false-positive cTn levels post-COVID-19 remains unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2025-0427_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This observational study prospectively included 35 healthy athletes (aged 16\u201375 years; 19 females, 16 males) who underwent post-COVID check-ups during 2022\u20132023. Athletes\u2019 cTn levels were measured using four different hs-cTn routine immunoassays. If discrepancies were noted between assays, further testing for macrotroponin was\u00a0conducted using protein G column, sucrose gradient\u00a0ultracentrifugation and anti-troponin autoantibody immunoassay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2025-0427_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventeen athletes had normal cTn levels across all assays, while 18 (51\u202f%) had elevated cTn, mostly cTnI. Despite elevated cTn levels, no signs of myocarditis or other cardiac conditions were found on electrocardiography, echocardiography, or CMR. Macrotroponin was confirmed among 16 of these 18 athletes. Further, IgG anti-troponin autoantibodies correlated significantly with the levels of the two most-commonly affected assays: hs-cTnI-Siemens Atellica and hs-cTnI-Abbott Alinity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2025-0427_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Post-COVID-19, nearly half of athletes showed elevated cTnI levels due to interference from macrotroponin. Awareness among physicians and laboratorians of this analytical confounder can avoid unnecessary invasive or costly diagnostic tests in athletes with false-positive cTnI levels after COVID-19.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/cclm-2025-0427","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T13:02:22Z","timestamp":1756126942000},"page":"2093-2103","source":"Crossref","is-referenced-by-count":4,"title":["False-positive cardiac troponin I values due to macrotroponin in healthy athletes after COVID-19"],"prefix":"10.1515","volume":"63","author":[{"given":"Angelika","family":"Hammerer-Lercher","sequence":"first","affiliation":[{"name":"Institute of Laboratory Medicine, Cantonal Hospital Aarau AG , Aarau , Switzerland"},{"name":"University of Bern , Bern , Switzerland"},{"name":"Central Medical Laboratories , Feldkirch , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine K.","family":"Kissel","sequence":"additional","affiliation":[{"name":"Medbase Sports Medical Center Abtwil, Swiss Olympic Medical Center , Abtwil , Switzerland"},{"name":"Cardiology Clinic Stadelhofen , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saara","family":"Wittfooth","sequence":"additional","affiliation":[{"name":"Biotechnology Unit, Department of Life Technologies , University Turku , Turku , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helea","family":"Junes","sequence":"additional","affiliation":[{"name":"Biotechnology Unit, Department of Life Technologies , University Turku , Turku , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emel","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Hur\u00e9","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Sanzone","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8682-9578","authenticated-orcid":false,"given":"Peter","family":"Neyer","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine, Cantonal Hospital Aarau AG , Aarau , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6647-6448","authenticated-orcid":false,"given":"Luca","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine, Cantonal Hospital Aarau AG , Aarau , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Manka","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Noack","sequence":"additional","affiliation":[{"name":"Medbase Sports Medical Center Abtwil, Swiss Olympic Medical Center , Abtwil , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dani\u00eblle","family":"Hof","sequence":"additional","affiliation":[{"name":"Unilabs , D\u00fcbendorf , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Hammarsten","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Institute of Biomedicine, University of Gothenburg , Gothenburg , Sweden"},{"name":"Department of Clinical Chemistry , Sahlgrenska University Hospital , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mueller","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"2025083005004175962_j_cclm-2025-0427_ref_001","doi-asserted-by":"crossref","unstructured":"Van Name, J, Wu, K, Xi, L. 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