Aim: Measurement of cardiac troponins is of great importance in the diagnosis and follow-up of acute myocardial infarction. The diagnostic specificity of myocardial infarction has increased with algorithms including serial troponin measurements. It is important that the measurements in the troponin cut-off values used to evaluate the risk of myocardial infarction in algorithms are reliable. In this study, it was aimed to evaluate the effect of hemolysis on clinical decision concentrations of the high sensitive cardiac troponin I (hs cTnI) test.

Material and Methods: Two pools were created from serum samples with the 99th percentile upper reference value (17.5 ng/L) of hs cTnI and the high-risk cut-off value (50 ng/L) as specified in the European Society of Cardiology 2020 manual. Hemolysate was spiked in both pools with a hemolysis index of 100 to 1000. The hs cTnI levels in hemolysate-added sera were measured in Beckman Coulter UniCel Dxl 800 immunoassay device. Levels of hemolysis were calculated as percentage change.

Results: Due to hemolysis, hs cTnI values decreased in varying proportions from 3.8% to 20.4% at 99th percentile concentration; values decreased from 4.3% to 20.0% in high-risk cut-off concentration.

Conclusions: In hemolyzed samples, hs cTnI values decrease, this decrease is not considered clinically significant until high hemolysis values. However, it should be kept in mind that a decrease that may occur even in a low hemolysis may lead to erroneous evaluations in clinical decision concentrations.