Key result
Post-marathon troponin elevations show no link to coronary atherosclerosis, plaque vulnerability, or skeletal muscle injury.
Why the study?
Data were limited on whether coronary atherosclerosis or skeletal muscle injury relate to cardiac troponin release after strenuous exercise such as a marathon.
Does marathon running-induced cardiac troponin elevation relate to coronary atherosclerosis, plaque vulnerability, or skeletal muscle injury in male runners?
Observational (n=40)
Does marathon running-induced cardiac troponin elevation relate to coronary atherosclerosis, plaque vulnerability, or skeletal muscle injury in male runners?
Asymptomatic cardiac troponin elevations are common after marathon running but are not related to markers of coronary atherosclerosis, plaque vulnerability, or skeletal muscle injury.
Answers are grounded in this paper and cite their sources.
Post-marathon troponin elevations warrant no atherosclerosis workup in asymptomatic runners; leaves open mechanisms and requires prospective validation.
BACKGROUND: Marathon running is associated with transient risk of sudden cardiac death and high cardiac troponin levels are common after race. There is limited data whether coronary atherosclerosis or skeletal muscle injury are related to troponin release caused by strenuous exercise. We aimed to assess whether coronary artery calcification (CAC), plaque vulnerability or skeletal muscle injury relate to cardiac troponin T (cTnT) elevations after marathon race. METHODS: In this observational study, 40 male runners participating in Paavo Nurmi 2018 Marathon were recruited with an open email invitation to evaluate the prevalence of post-race cTnT elevations and their predictors. In addition to baseline and post-race laboratory investigations, 28 runners aged >44 years underwent CAC measurement with computed tomography. Coronary plaque vulnerability was evaluated by free pregnancy-associated plasma protein A (fPAPP-A) concentration and skeletal muscle injury by skeletal troponin I (skTnI) measurement. RESULTS: = -0.26, p = 0.11) was non-significant. CAC was detected (Agatston score > 0) in 15 (53.6%) participants, with a median score of 2.0 (interquartile range [IQR] 80). There was no correlation between cTnT with CAC score or post-race fPAPP-A levels. CONCLUSIONS: Asymptomatic cardiac troponin elevations are common after prolonged strenuous exercise, but are not related to markers of coronary atherosclerosis, plaque vulnerability or skeletal muscle injury.
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Paana et al. (2019) conducted an observational in Marathon runners (n=40). Marathon running was evaluated on Correlation of post-race cTnT elevations with coronary artery calcification, fPAPP-A, and skTnI (-0.26, p=0.11). Asymptomatic cardiac troponin elevations after marathon running are common but not related to markers of coronary atherosclerosis, plaque vulnerability, or skeletal muscle injury (p=0.11).
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