Exercise-Induced Cardiac Troponin T Release: A Meta-Analysis

SHAVE, ROBERT1; GEORGE, KEITH P.2; ATKINSON, GREG2; HART, EMMA1; MIDDLETON, NATALIE1; WHYTE, GREG2; GAZE, DAVID3; COLLINSON, PAUL O.3

Medicine & Science in Sports & Exercise: December 2007 - Volume 39 - Issue 12 - pp 2099-2106
doi: 10.1249/mss.0b013e318153ff78
CLINICAL SCIENCES: Clinically Relevant

Purpose: Cardiac troponin T (cTnT) is a highly specific marker of myocardial damage and used clinically in the diagnosis of acute myocardial infarction (AMI). Release of cTnT has been demonstrated in several small studies after endurance exercise. The purpose of this study was to explore, using a meta-analytic approach, the incidence of postexercise cTnT release after endurance exercise.

Methods: Articles identified via Pubmed, SportDiscus, and Embase (1997-2006) searches using the key words cardiac troponin T, cTnT, cardiac biomarkers, and exercise; a search of bibliographies; and consultation with experts in the field were entered into a random-effects meta-analysis. We identified 26 relevant studies (1120 cases). Age, gender, and body mass of participants, as well as exercise mode and duration, were explored as possible moderator variables with meta-regressions.

Results: Postexercise cTnT levels exceeded the assay detection limit in 47% of participants (95% CI = 39-56%). The detection of postexercise cTnT after cycling events was approximately half that of running events (27 vs 52%, P = 0.042). The detection of postexercise cTnT decreased slightly as event duration increased (P = 0.022) and mean body mass decreased (P = 0.0033). Postexercise detection of cTnT was not affected by age (P= 0.309) and was only slightly higher for studies with more males in the sample (P = 0.028).

Conclusions: Exercise-induced cTnT release is apparent in almost half of the endurance athletes who have been studied to date. Relatively heavy individuals competing in shorter endurance events, primarily running marathons, are slightly more likely to demonstrate elevated cTnT postexercise than other athletes. These data are useful for clinicians evaluating athletes with cTnT elevations after competitive endurance exercise events.

1Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge, UNITED KINGDOM; 2Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UNITED KINGDOM; and 3Department of Chemical Pathology, St.George's Hospital Medical School, London, UNITED KINGDOM

Address for correspondence: Rob Shave, Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge, Middlesex, UB8 3PH, UK; E-mail: rob.shave@brunel.ac.uk.

Submitted for publication April 2007.

Accepted for publication July 2007.

©2007The American College of Sports Medicine