Exercise-Induced Cardiac Troponin I Increase and Incident Mortality and Cardiovascular Events

• DOI: 10.1161/circulationaha.119.041627
• Publication Date: 2019-08-12T09:00:20Z
• Authors: Vincent L. Aengev...; Maria T.E. Hopman; Paul D. Thompson; Esmée A. Bakker; Keith P. George; Dick H.J. Thijssen; Thijs M.H. Eijsvo...
• Keywords: Interquartile range; Troponin T

Blood concentrations of cardiac troponin above the 99th percentile are a key criterion for diagnosis acute myocardial injury and infarction. Troponin concentrations, even below percentile, predict adverse outcomes in patients general population. Elevated commonly observed after endurance exercise, but clinical significance this increase is unknown. We examined association between postexercise I long-distance walkers. measured 725 participants (61 [54-69] yrs) before immediately 30 to 55 km walking. tested an (>0.040 µg/L) composite end point all-cause mortality major cardiovascular events (myocardial infarction, stroke, heart failure, revascularization, or sudden arrest). Continuous variables were reported as mean ± standard deviation when normally distributed median [interquartile range] not distributed. Participants walked 8.3 [7.3-9.3] hours at 68±10% their maximum rate. Baseline >0.040 µg/L 9 (1%). increased walking (P<.001), with 63 (9%) demonstrating concentration µg/L. During 43 [23-77] months follow-up, 62 experienced point; 29 died 33 had events. Compared 7% ≤0.040 (log-rank P<.001), 27% point. The hazard ratio was 2.48 (95% CI, 1.29-4.78) adjusting age, sex, risk factors (hypertension, hypercholesterolemia diabetes mellitus), diseases failure), baseline concentrations. Exercise-induced elevations independently predicted higher cohort older increases may be benign physiological response early marker future