Occult obstructive coronary artery disease is associated with prolonged cardiac troponin elevation following strenuous exercise
Why the study?
Sudden cardiac death in middle-aged recreational athletes is predominantly caused by myocardial ischaemia, prompting investigation into whether post-exercise cTnI and cTnT can identify occult obstructive CAD.
Does prolonged cardiac troponin elevation following strenuous exercise identify occult obstructive coronary artery disease in asymptomatic recreational athletes?
Population
120 asymptomatic recreational cyclists completing a 91-km mountain bike race
Comparison
80 participants with highest post-exercise cTnI vs 40 reference subjects with moderately elevated cTnI
Design
Prospective observational study
Follow-up
24 h after the race
Authors
Discussion
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Member takes
Implication
Should not yet change practice in recreational athletes; leaves open 24-h post-exercise troponin for occult CAD detection.
Structured PICO
Does prolonged cardiac troponin elevation following strenuous exercise identify occult obstructive coronary artery disease in asymptomatic recreational athletes?
P
Population
120 asymptomatic recreational cyclists with no known cardiovascular disease or medication, selected from a larger cohort of 1002 based on post-exercise cTnI levels (80 with highest post-exercise cTnI and 40 reference subjects with moderately elevated cTnI). Median age 45 (36-52) years, 74% male.
I
Intervention
Measurement of cardiac troponin I and T (cTnI and cTnT) at 3 hours and 24 hours after strenuous exercise (91-km mountain bike race) followed by coronary computed tomography angiography.
O
Outcome
Presence of occult obstructive coronary artery disease on coronary computed tomography angiography.surrogate
Prolonged elevation of cardiac troponins 24 hours after strenuous exercise is associated with occult obstructive coronary artery disease in asymptomatic recreational athletes, suggesting a potential screening strategy.
Cite This Study
Omland et al. (2019) studied this question.