Defining the burden of artefactual troponin elevation on hospital resource management in the ED

MacHSR Future Leaders Fellowship program (2023 cohort).

Cardiac troponin is a pivotal biomarker used to detect myocardial injury in the assessment and diagnosis of acute coronary syndrome (ACS). In a sizeable group of patients, however, ‘interference’ with troponin measurement causes troponin elevation in the absence of acute myocardial injury. By causing troponin elevation, troponin assay interference erroneously stratifies patients as high risk, precluding early rule-out and necessitating continuous cardiac monitoring and further investigation. A proportion of patients with troponin interference unnecessarily undergo CT and direct coronary angiography, which exposes them to risk and wastes health sector resources.

This project will examine the prevalence and impact of troponin interference in the Emergency Department (ED). We will determine how frequently troponin interference occurs in patients undergoing troponin testing in ED, and the downstream impact on patient management and health sector costs. Our ultimate goal is to deliver a cost-effective method to detect troponin interference in real-time, thereby improving clinical management of ACS and resource allocation in the ED. Aligning directly with a key strategic objective of SVHM to promote clinical innovation and deliver safe, high-quality care, our findings will be relevant to healthcare services throughout Australia and worldwide that are affected by troponin interference.