Øyunn Kleiven has studied troponin and CRP levels following Nordsjørittet – a 91 km long bike race.
Most cyclist have troponins above the 99th percentile after a strenous competition.
- Blood pressure and race time are independent predictors of the troponin response.
- Increased troponins 24 hours after an endurance competition could be a warning sign of coronary artery disease.
Thesis: The clinical significance of exercise-induced cardiac biomarkers
Candidate: Øyunn Kleiven
Time: January 17, 2020 at 10:30
Place: Stavanger University Hospital, Sydbygg: 1st floor Aula
Link to university website (in Norwegian)
(1) Three hours after finishing a long bike competition, 92% of healthy athletes had troponin T values indicative of myocardial infarction. 84% had troponin I levels above the 99th percentile. The levels were still increased in almost 20 % the next day. The better race performance, the higher troponin increase. Higher blood pressure before the race was also a predictor of higher troponin elevation.
The study includes 1002 recreational cyclists who took part in the 91-km long mountain bike race Nordsjørittet. Age, gender, body mass index and training experience did not influence the increase in troponin. Neither did the Framingham cardiovascular risk score.
(2) Troponin I concentrations 24 hours post-race were higher in cyclists with occult obstructive coronary artery disease. From 1002 participants, the 80 with the highest troponin I levels after the race were selected for coronary CT angiography, along with 40 reference subjects with more moderately elevated troponin levels. Eight of the nine subjects with coronary artery disease were among the 80 high troponin I responders.
(3) The levels of C-reactive protein (CRP) was higher in the least fit Nordsjørittet participants. However, Kleiven and co-workers found no association between troponin- and CRP response following the race.
(1) Kleiven, Ø., Omland, T., Skadberg, Ø., Melberg, T. H., Bjørkavoll-Bergseth, M. F., Auestad, B., Bergseth, R., Greve, O. J., Aakre, K. M., & Ørn, S. (2019). Race duration and blood pressure are major predictors of exercise-induced cardiac troponin elevation. International journal of cardiology, 283, 1-8.
(2) Kleiven, Ø., Omland, T., Skadberg, Ø., Melberg, T. H., Bjørkavoll-Bergseth, M. F., Auestad, B., Bergseth, R., Greve, O. J., Aakre, K. M., & Ørn, S. (2019). Occult obstructive coronary artery disease is associated with prolonged cardiac troponin elevation following strenuous exercise. European journal of preventive cardiology, 2047487319852808