Variability and Error in Cardiac Troponin Testing

OBJECTIVES: To provide a comprehensive overview of the complexities associated with cardiac troponin (cTn) testing. An emphasis is placed on the sources of error, organized into the preanalytical, analytical, and postanalytical phases of the testing pathway. Controversial areas are also explored. METHODS: A case scenario and review of the relevant literature describing laboratory considerations involving cTn testing are described. RESULTS: Advanced comprehension of the specific assay used in a given laboratory is necessary for optimal reporting, utilization, and quality monitoring of cTn. CONCLUSIONS: cTn assays are reliable diagnostic tests for acute myocardial infarction, but understanding their limitations is required for appropriate result interpretation.