Key result
Vigorous exercise the week before STEMI linked to ~70% lower peak hs-cTnT.
Why the study?
Little was known about whether exercise engagement prior to MI is related to post-MI cardiac biomarker concentrations and clinical outcomes.
Does vigorous exercise in the week prior to MI reduce post-MI peak cardiac biomarker concentrations in hospitalised STEMI patients?
Observational (n=98)
Does vigorous exercise in the week prior to MI reduce post-MI peak cardiac biomarker concentrations in hospitalised STEMI patients?
Absolute Event Rate: 941% vs 3136%
p-value: p=0.010
Engagement in vigorous exercise in the week prior to STEMI is associated with lower peak cardiac biomarker concentrations, suggesting potential cardioprotective preconditioning.
May indicate preconditioning in STEMI; hypothesis-generating and requires randomized confirmation before practice implications.
Background: Regular exercise training is an important factor in prevention of myocardial infarction (MI). However, little is known whether exercise engagement prior to MI is related to the magnitude of post-MI cardiac biomarker concentrations and clinical outcomes. Objectives: We tested the hypothesis that exercise engagement in the week prior MI is related to lower cardiac biomarker concentrations following ST-elevated MI (STEMI). Methods: We recruited hospitalised STEMI patients and assessed the amount of exercise engagement in the 7 days preceding MI onset using a validated questionnaire. Patients were classified as 'exercise' if they performed any vigorous exercise in the week prior MI, or as 'control' if they did not. Post-MI peak concentrations of high-sensitive cardiac troponin T (peak-hs-cTnT) and creatine kinase (peak-CK) were examined. We also explored whether exercise engagement prior MI is related to the clinical course (duration of hospitalisation and incidence of in-hospital, 30-day and 6-month major adverse cardiac events (reinfarction, target vessel revascularisation, cardiogenic shock or death)). Results: In total, 98 STEMI patients were included, of which 16% (n=16) was classified as 'exercise', and 84% (n=82) as 'control'. Post-MI peak-hs-cTnT and peak-CK concentrations were lower in the exercise group (941 (645-2925) ng/mL; 477 (346-1402) U/L, respectively) compared with controls (3136 (1553-4969) ng/mL, p=0.010; 1055 (596-2019) U/L, p=0.016, respectively). During follow-up, no significant differences were found between both groups. Conclusion: Engagement in exercise is associated with lower cardiac biomarker peak concentrations following STEMI. These data could provide further support for the cardiovascular health benefits of exercise training.
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Koning et al. (2023) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=98). Vigorous exercise in the 7 days preceding MI onset vs. No vigorous exercise in the week prior to MI was evaluated on Post-MI peak concentrations of high-sensitive cardiac troponin T (peak-hs-cTnT) (p=0.010). Engagement in vigorous exercise in the week prior to STEMI was associated with significantly lower peak high-sensitive cardiac troponin T (941 vs 3136 ng/mL, p=0.010) compared to controls.
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