P1513Exercise-induced cardiac troponin I release and incident cardiovascular morbidity and mortality

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Aengevaeren ◽  
M T E Hopman ◽  
P D Thompson ◽  
E A Bakker ◽  
K P George ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Primary Endpoint ◽  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
Troponin I ◽  
Long Distance ◽  
Post Exercise ◽  
All Cause Mortality ◽  
Exercise Induced

Abstract Background Blood concentrations of cardiac troponin I (cTnI) above the 99th percentile (upper reference limit, URL) are a key criterion for the diagnosis of acute myocardial injury and infarction. cTnI concentrations, even below the URL, also predict adverse outcomes in general and patient populations. cTnI increases after exercise, but the clinical significance of this exercise-induced cTnI increase is unknown. We examined the association between exercise-induced cTnI elevations and clinical outcomes in long-distance walkers. Methods cTnI was measured in 726 participants (median 61 [54–69] yrs) before and immediately after 30–55 km of walking. The primary endpoint was a composite of all-cause mortality and major adverse cardiovascular events (MACE, i.e. myocardial infarction, stroke, heart failure, revascularization or sudden cardiac arrest). Results Participants walked 498 [440–555] min at 68±10% of their maximum heart rate. Baseline cTnI concentrations were 2 [0–8] ng/L, with 9 participants (1%) demonstrating a baseline cTnI value above the URL (>40 ng/L). cTnI increased after walking (8 [1–18] ng/L, p<0.001) and 63 participants (9%) had a post-exercise cTnI value >URL. During 43 [23–77] months of follow-up, 62 participants (9%) experienced a primary endpoint; 29 died and 33 had MACE. 27% of participants with post-exercise cTnI >URL experienced a primary endpoint compared to only 7% with cTnI below the URL (log-rank p<0.001). The hazard ratio was 2.35 (95% CI: 1.21–4.53) after adjusting for age, sex, cardiovascular risk factors (hypertension, hypercholesterolemia or diabetes mellitus), cardiovascular diseases (myocardial infarction, stroke or heart failure) and baseline cTnI. Kaplan-Meier of Mortality and MACE Conclusion Post-exercise cTnI concentrations >URL were associated with higher all-cause mortality and MACE, independent of age, sex, presence of cardiovascular risk factors or cardiovascular diseases and baseline cTnI concentrations in a large cohort of older long-distance walkers. Exercise-induced increases in cTnI may not be a benign physiological response to exercise in all, but an early marker of future mortality and cardiovascular events. Acknowledgement/Funding V.L.A was supported by a grant from the Radboud Institute for Health Sciences, T.M.H.E by a Horizon 2020 grant from the European Commission

scholarly journals Exercise-Induced Cardiac Troponin I Increase and Incident Mortality and Cardiovascular Events

Circulation ◽  
2019 ◽  
Vol 140 (10) ◽  
pp. 804-814 ◽  
Author(s):  
Vincent L. Aengevaeren ◽  
Maria T.E. Hopman ◽  
Paul D. Thompson ◽  
Esmée A. Bakker ◽  
Keith P. George ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Exercise Induced

scholarly journals Electrocardiographic unrecognized myocardial infarction does not improve prediction of cardiovascular events beyond traditional risk factors. The Tromsø Study

2017 ◽  
Vol 25 (1) ◽  
pp. 78-86 ◽  
Author(s):  
Andrea Milde Øhrn ◽  
Henrik Schirmer ◽  
Inger Njølstad ◽  
Ellisiv B Mathiesen ◽  
Anne E Eggen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Events ◽  
Hazard Ratio ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Traditional Risk Factors

Background Unrecognized myocardial infarction (MI) is a frequent and intriguing entity associated with a similar risk of death as recognized MI. Previous studies have not fully addressed whether the poor prognosis is explained by traditional cardiovascular risk factors. We investigated whether electrocardiographically detected unrecognized MI was independently associated with cardiovascular events and death and whether it improved prediction for future MI in a general population. Design Prospective cohort study. Methods We studied 5686 women and men without clinically recognized MI at baseline in 2007–2008. We assessed the risk of future MI, stroke and all-cause mortality in persons with unrecognized MI compared with persons with no MI during 31,051 person-years of follow-up. Results In the unadjusted analyses, unrecognized MI was associated with increased risk of future recognized MI (hazard ratio 1.84, 95% confidence interval (CI) 1.15–2.96) and all-cause mortality (hazard ratio 1.78, 95% CI 1.21–2.61), but not stroke (hazard ratio 1.09, 95% CI 0.56–2.17). The associations did not remain significant after adjustment for traditional risk factors (hazard ratio 1.25, 95% CI 0.76–2.06 and hazard ratio 1.38, 95% CI 0.93–2.05) for MI and all-cause mortality respectively. Unrecognized MI did not improve risk prediction for future recognized MI using the Framingham Risk Score ( p = 0.96) or the European Systematic COronary Risk Evaluation ( p = 0.65). There was no significant sex interaction regarding any of the endpoints. Conclusion Electrocardiographic unrecognized MI was not significantly associated with future risk of MI, stroke or all-cause mortality in the general population after adjustment for the traditional cardiovascular risk factors, and it did not improve prediction of future MI.

scholarly journals High-Sensitivity Cardiac Troponin I Is a Strong Predictor of Cardiovascular Events and Mortality in the AGES-Reykjavik Community-Based Cohort of Older Individuals

2016 ◽  
Vol 62 (4) ◽  
pp. 623-630 ◽  
Author(s):  
Ingunn Thorsteinsdottir ◽  
Thor Aspelund ◽  
Elias Gudmundsson ◽  
Gudny Eiriksdottir ◽  
Tamara B Harris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
Troponin I ◽  
Strong Predictor ◽  
Large Population ◽  
High Sensitivity ◽  
Cardiac Troponin I ◽  
Conventional Risk Factors

Abstract BACKGROUND The objective of this study was to investigate the predictive power of a high-sensitivity cardiac troponin I (hs-cTnI) assay for cardiovascular events and mortality in a large population of older community dwellers. METHODS Blood was collected from 5764 individuals (age 66–98 years) during the period of 2002–2006 and the outcome as to all-cause death and incidence of cardiovascular disease (CVD) and coronary heart disease (CHD) followed up to 10 years. hs-cTnI (Abbott) was measured in serum to assess the association of this marker with CVD, CHD and death, and finally, to compare the results with conventional risk factors by multivariable statistical analysis. RESULTS The median (interquartile range) concentrations of hs-cTnI were 8.4 ng/L (5.6–14.2 ng/L) and 5.3 ng/L (3.8–8.1 ng/L) in men (2416) and women (3275), respectively, and the concentrations increased linearly with age. Outcomes as to all-cause death and incidence of CVD and CHD were significantly associated with increasing concentrations of hs-cTnI beginning well below the 99th percentile concentrations. The associations with outcome remained after adjustments for conventional risk factors and were similar in men and women. CONCLUSIONS Our findings suggest that hs-cTnI reflects the status of the myocardium even in seemingly healthy individuals and that the measurements of hs-cTnI may be useful for primary prediction of heart disease; this should form the basis for future prospective clinical trials for determining whether measuring hs-cTnI can be used in the prevention of CVD/CHD.

scholarly journals Cardiac Troponin Elevation After Long-Distance Cycling is Associated with Oxidative Stress and Exercise Intensity: An Observational Study

2020 ◽  
Vol 11 (4) ◽  
Author(s):  
Mahalul Azam ◽  
Sri Ratna Rahayu ◽  
Arulita Ika Fibriana ◽  
Hardhono Susanto ◽  
Martha Irene Kartasurya ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Exercise Intensity ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Density Lipoprotein ◽  
Long Distance ◽  
Troponin Elevation ◽  
Post Exercise ◽  
Artery Disease ◽  
Blood Specimens

Background: To date, the mechanisms of post-exercise cardiac troponin elevation are debatable. Previous studies have reported that oxidative stress happens after extended exercise. Objectives: This study purposed to establish the association between the elevation of malondialdehyde (MDA), which is a marker of oxidative stress, and cardiac troponin-I (cTn-I) after prolonged cycling. Methods: Ninety-two males in Indonesian cycling tours participated in the present study. Baseline and post-exercise blood specimens were obtained to define MDA and cTn-I levels. The elevations of MDA and cTn-I were determined as positive differences of post-cycling MDA and cTn-I levels to the baseline, respectively. Results: Eighty-eight participants (age, mean = 45.3 years old, [SD]:11.47; body mass index (BMI), mean=24.2 kg/m2, [SD]: 3.03) finished the cycling tours. Subjects’ characteristics were comparable based on the touring category, except for the family history of coronary artery disease, high-density lipoprotein cholesterol level, neutrophil count, resting heart rate, exercise intensity, and cTn-I elevation. MDA significantly escalated at the level of 210.90 µmol/mL at post-exercise, from 190.18 µmol/mL at baseline. cTn-I also increased at the level of 13.65 ng/dL from 5.16 ng/dL. The elevation of MDA was related to the elevation of cTn-I. Elevation of cTn-I after prolonged cycling was contributed by elevation of MDA and exercise intensity. Conclusions: The present findings support existing confirmation that cTn-I elevation after prolonged exercise is related to oxidative stress and exercise intensity.

scholarly journals Evaluation of Troponin I Serum Level in Patients With Peritoneal Dialysis and Relationship Between Troponin I and Cardiovascular Risk Factors

2020 ◽  
Author(s):  
Shahram Taheri ◽  
Ali Asghar Pilehvarian ◽  
Afsoon Emami Naeini ◽  
Fariba Kushki ◽  
Firouzeh Moeinzadeh
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Cardiovascular Risk ◽  
Serum Level ◽  
Cardiovascular Risk Factors ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Ctni Level

End-stage renal disease is a situation that predisposes the patients to cardiovascular disease, especially myocardial infarction (MI). A valuable biomarker for the diagnosis of this event is cardiac troponin. Although some asymptomatic patients show high plasma levels of cardiac troponin I, it is still the most sensitive variable in MI. All patients more than 18-year-old, on chronic ambulatory peritoneal dialysis (CAPD) for at least three months, and did not have a history of acute myocardial infarction or hospitalization for CVD during last month are included in a cross-sectional descriptive study. Troponin I serum level was measured by VIDAS Troponin I Ultra (TNIU) Assay. Correlation between serum troponin level and cardiovascular risk factors are evaluated. In this study, 52% of patients were male. The mean cTnI level was 0.025±0.044 ng/mL, less than 0.11 ng/mL, and only five patients had cTnI level more than the laboratory threshold. The cut-off level of cTnI for diagnosing cardiovascular disease must be re-evaluated and maybe increase to 0.3 ng/mL. Indeed, the asymptomatic patient may need more close observation for cardiovascular disease. © 2019 Tehran University of Medical Sciences. All rights reserved. 

scholarly journals Diagnostic Application of Postmortem Cardiac Troponin I Pericardial Fluid/Serum Ratio in Sudden Cardiac Death

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 614
Author(s):  
Diana Hernández-Romero ◽  
María del Rocío Valverde-Vázquez ◽  
Juan Pedro Hernández del Rincón ◽  
José A. Noguera-Velasco ◽  
María D. Pérez-Cárceles ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Troponin ◽  
Cardiac Death ◽  
Troponin I ◽  
Sampling Site ◽  
Pericardial Fluid ◽  
Cardiac Troponin I ◽  
Control Group ◽  
Complementary Method

In approximately 5% of unexpected deaths, establishing a conclusive diagnosis exclusively on the basis of anatomo-pathological findings in a classic autopsy is difficult. Postmortem biomarkers have been actively investigated as complementary indicators to help to reach valid conclusions about the circumstances of death. Several studies propose either the pericardial fluid or peripheral veins as a location for troponin determination, but the optimum sampling site is still a matter of debate. Our objective was to evaluate the association between the ratio of troponin values in the pericardial fluid and serum (determined postmortem) and the diagnosis of acute myocardial infarction (AMI) in the context of sudden cardiac death. We included 175 forensic cases. Two groups were established: AMI deaths (48; 27.4%) and the control group (127; 72.6%). The cardiac Troponin I (cTnI) values in the pericardial fluid and the troponin ratio were found to be associated with the cause of death. Univariate regression analyses showed that both age and the cTnI ratio were significantly associated with the diagnosis of AMI death. In a multivariate analysis, adjusting for confounding factors, the age and cTnI ratio were independent predictors of death from myocardial infarction. We performed a receiver operating characteristic (ROC) curve for the cTnI ratio for AMI death and selected a cut-off point. Our biomarker was found to be a valuable and highly effective tool for use in the forensic field as a complementary method to facilitate diagnosis in nonconclusive autopsies.

scholarly journals Exercise-Induced Release of Cardiac Troponins in Adolescent vs. Adult Swimmers

2021 ◽  
Vol 18 (3) ◽  
pp. 1285
Author(s):  
Rafel Cirer-Sastre ◽  
Francisco Corbi ◽  
Isaac López-Laval ◽  
Luis Enrique Carranza-García ◽  
Joaquín Reverter-Masià
Keyword(s):  
Cardiac Troponin ◽  
Healthy Subjects ◽  
Troponin T ◽  
Training Experience ◽  
Post Exercise ◽  
Baseline Values ◽  
Exercise Induced ◽  
Cardiac Troponins ◽  
Similar Peak ◽  
Apparently Healthy

To examine the exercise-induced release of cardiac troponin T (cTnT) in adolescent and adult swimmers. Thirty-two trained male (18 adolescents, 14 adults) swam at maximal pace in a 45 min distance trial, and blood samples were drawn before, immediately and 3 h after exercise for subsequent cTnT analysis and comparison. Having comparable training experience and baseline values of cTnT (p = 0.78 and p = 0.13), adults exercised at lower absolute and relative intensity (p < 0.001 and p < 0.001, respectively), but presented higher immediate cTnT after exercise than adolescents (p < 0.001). Despite that, peak concentrations were observed at 3 h post exercise and peak elevations were comparable between groups (p = 0.074). Fourteen (44%) apparently healthy subjects exceeded the cutoff value for myocardial infarction (MI). Adolescents presented a delayed elevation of cTnT compared with adults, but achieved similar peak values.

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