Pre-analytical interference in point-of-care troponin T testing: a case series.

Objectives: To examine the impact of haematological and biochemical abnormalities on the failure of point-of-care troponin T (POCT) testing in patients with suspected acute coronary syndrome (ACS).

Case Presentation: Five patients underwent Roche Troponin T Card Test (lateral flow immunoassay) in an emergency setting. Despite correct sampling and procedural adherence, no valid results were obtained resulting in an aborted test. Laboratory analysis revealed severe anaemia, polycythaemia, leucocytosis, thrombocytopenia, and hepatic and renal dysfunction across cases. After stabilization, repeat POCT yielded valid results in all survivors, correlating with normalized haematological parameters.

Conclusions: Pre-analytical factors such as extreme haematocrit, leucocytosis, and biochemical derangements can cause POCT failure. Pre-testing screening and guideline updates are essential to optimize POCT reliability in acute care.