Exercise-Induced cTnI Increase Associated With Higher Mortality and Cardiovascular Events
- This study recruited 725 individuals (mean age, 61) who participated in a large long-distance walking event in the Netherlands and examined associations between elevated post-exercise cardiac troponin I (cTnI) concentrations (>0.040 μm/L) and outcomes over a mean follow-up of 43 months. Prior to cTnI measurement, participants walked 30 to 55 km. The primary outcome was a composite endpoint of all-cause mortality and major adverse cardiovascular events (sudden cardiac arrest, myocardial infarction, revascularization, stroke, or heart failure). Post-exercise cTnI was above the 99th percentile (>0.40 μm/L) in 1% of participants. During follow-up, the composite endpoint occurred in 9% of participants. The composite endpoint occurred significantly more often in participants with post-exercise cTnI above the 99th percentile (27%) than in those with cTnI at or below the 99th percentile (HR, 2.48 in an adjusted analysis).
- These findings suggest that elevated post-exercise cTnI may not be a benign finding and that clinicians may wish to consider additional monitoring for patients with this finding, who may have subclinical cardiac pathology.
- This study recruited 725 individuals (mean age, 61) who participated in a large long-distance walking event in the Netherlands and examined associations between elevated post-exercise cardiac troponin I (cTnI) concentrations (>0.040 μm/L) and outcomes over a mean follow-up of 43 months. Prior to cTnI measurement, participants walked 30 to 55 km. The primary outcome was a composite endpoint of all-cause mortality and major adverse cardiovascular events (sudden cardiac arrest, myocardial infarction, revascularization, stroke, or heart failure). Post-exercise cTnI was above the 99th percentile (>0.40 μm/L) in 1% of participants. During follow-up, the composite endpoint occurred in 9% of participants. The composite endpoint occurred significantly more often in participants with post-exercise cTnI above the 99th percentile (27%) than in those with cTnI at or below the 99th percentile (HR, 2.48 in an adjusted analysis).
- These findings suggest that elevated post-exercise cTnI may not be a benign finding and that clinicians may wish to consider additional monitoring for patients with this finding, who may have subclinical cardiac pathology.
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