Elevations in cardiac troponin measurements: False false-positivesThe real truth

The development of assays for troponin markers has improved cardiovascular diagnosis. However, because the assays are so sensitive and specific, elevations are often detected in patients without overt coronary artery disease. Some would like to attribute such elevations to biological “false positives.” That is rarely the case. There can be analytic false positives but most such elevations are indicative of subtle degrees of cardiac injury, many not related to ischemic heart disease. The spectrum of such increases and their potential etiologies are elaborated in this article.