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

AbstractElectroconvulsive therapy (ECT) is a remarkably safe procedure. However, there might exist a subgroup of patients with an increased risk for cardiovascular events. The cardiac-specific enzymes high-sensitive cardiac troponin I (hscTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured before and after ECT in 23 patients. No relevant increase of hscTnI after ECT was found. Mean NT-proBNP levels were higher after ECT and in three patients a new NT-proBNP elevation after ECT was identified. In conclusion, our small study did not find any evidence for myocardial damage due to ECT by measuring hsTnI, but an increase of NT-proBNP, whose clinical relevance could only be speculated, yet.

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Direct comparison of cardiac troponin I and cardiac troponin T in the detection of exercise-induced myocardial ischemia

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2015.12.005 ◽

2016 ◽

Vol 49 (6) ◽

pp. 421-432 ◽

Cited By ~ 14

Author(s):

Seoung Mann Sou ◽

Christian Puelacher ◽

Raphael Twerenbold ◽

Max Wagener ◽

Ursina Honegger ◽

...

Keyword(s):

Myocardial Ischemia ◽

Cardiac Troponin ◽

Troponin I ◽

Troponin T ◽

Cardiac Troponin I ◽

Cardiac Troponin T ◽

Exercise Induced

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Temporal Changes in Cardiac Troponin I Are Associated with Risk of Cardiovascular Events in the General Population: The Nord-Trøndelag Health Study

Clinical Chemistry ◽

10.1373/clinchem.2018.301069 ◽

2019 ◽

Vol 65 (7) ◽

pp. 871-881 ◽

Cited By ~ 9

Author(s):

Magnus N Lyngbakken ◽

Helge Røsjø ◽

Oddgeir L Holmen ◽

Håvard Dalen ◽

Kristian Hveem ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

General Population ◽

Cardiac Troponin ◽

Cardiovascular Events ◽

Troponin I ◽

Temporal Changes ◽

Relative Increase ◽

Cardiac Troponin I ◽

Recent Measurement

Abstract BACKGROUND Cardiac troponins are associated with cardiovascular risk in the general population, but whether temporal changes in cardiac troponin I provide independent prognostic information remains uncertain. Using a large community-based cohort with follow-up close to the present day, we aimed to investigate the associations between temporal changes in cardiac troponin and cardiovascular events. METHODS We measured cardiac troponin I with a high-sensitivity assay (hs-cTnI) in 4805 participants attending both the second (HUNT 2, 1995–97) and third wave (HUNT 3, 2006–2008) of the prospective observational Nord-Trøndelag Health (HUNT) Study. We constructed statistical models with both relative and absolute changes of hs-cTnI from HUNT 2 to HUNT 3. A composite end point of cardiovascular death or first admission for myocardial infarction or heart failure was generated. RESULTS Participants with relative decrease in hs-cTnI were more frequently younger and female and had lower blood pressure and body mass index. Participants with relative increase in hs-cTnI more frequently were older and male, with higher systolic blood pressure. The adjusted hazard ratio (HR) for relative increase in hs-cTnI was 1.68 (95% CI, 1.16–2.42) and the adjusted HR for relative decrease was 1.19 (95% CI, 0.84–1.68). Absolute increases in hs-cTnI exhibited similar prognostic properties as relative increases in hs-cTnI. The most recent measurement of hs-cTnI outperformed the change variables in discrimination and reclassification models. CONCLUSIONS Both relative and absolute increases in hs-cTnI are independently associated with cardiovascular risk. For refinement of risk prediction models, the most recent measurement of hs-cTnI should be preferred in clinical practice.

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

European Heart Journal ◽

10.1093/eurheartj/ehz748.0275 ◽

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

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High-sensitivity cardiac troponin I is a biomarker for occult coronary plaque burden and cardiovascular events in patients with rheumatoid arthritis

Rheumatology ◽

10.1093/rheumatology/key057 ◽

2018 ◽

Vol 57 (6) ◽

pp. 1080-1088 ◽

Cited By ~ 7

Author(s):

George A Karpouzas ◽

Joel Estis ◽

Panteha Rezaeian ◽

John Todd ◽

Matthew J Budoff

Keyword(s):

Rheumatoid Arthritis ◽

Cardiac Troponin ◽

Cardiovascular Events ◽

Troponin I ◽

High Sensitivity ◽

Coronary Plaque ◽

Cardiac Troponin I ◽

Plaque Burden

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Impact of Smoking on Circulating Cardiac Troponin I Concentrations and Cardiovascular Events in the General Population

Circulation ◽

10.1161/circulationaha.116.023726 ◽

2016 ◽

Vol 134 (24) ◽

pp. 1962-1972 ◽

Cited By ~ 20

Author(s):

Magnus Nakrem Lyngbakken ◽

Julia Brox Skranes ◽

James A. de Lemos ◽

Ståle Nygård ◽

Håvard Dalen ◽

...

Keyword(s):

General Population ◽

Cardiac Troponin ◽

Cardiovascular Events ◽

Troponin I ◽

Cardiac Troponin I

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Clinical benefit of high-sensitivity cardiac troponin I in the detection of exercise-induced myocardial ischemia

American Heart Journal ◽

10.1016/j.ahj.2015.11.010 ◽

2016 ◽

Vol 173 ◽

pp. 8-17 ◽

Cited By ~ 38

Author(s):

Gino Lee ◽

Raphael Twerenbold ◽

Yunus Tanglay ◽

Tobias Reichlin ◽

Ursina Honegger ◽

...

Keyword(s):

Myocardial Ischemia ◽

Clinical Benefit ◽

Cardiac Troponin ◽

Troponin I ◽

High Sensitivity ◽

Cardiac Troponin I ◽

Exercise Induced

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Determinants of Interindividual Variation in Exercise‐Induced Cardiac Troponin I Levels

Journal of the American Heart Association ◽

10.1161/jaha.121.021710 ◽

2021 ◽

Author(s):

Magnus Bjørkavoll‐Bergseth ◽

Christine Bjørkvik Erevik ◽

Øyunn Kleiven ◽

Thijs M. H. Eijsvogels ◽

Øyvind Skadberg ◽

...

Keyword(s):

Exercise Test ◽

High Intensity ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiopulmonary Exercise Test ◽

Cardiac Troponin I ◽

Interindividual Variation ◽

Cardiopulmonary Exercise ◽

Link Type ◽

Exercise Induced

Background Postexercise cardiac troponin levels show considerable interindividual variations. This study aimed to identify the major determinants of this postexercise variation in cardiac troponin I (cTnI) following 3 episodes of prolonged high‐intensity endurance exercise. Methods and Results Study subjects were recruited among prior participants in a study of recreational cyclists completing a 91‐km mountain bike race in either 2013 or 2014 (first race). In 2018, study participants completed a cardiopulmonary exercise test 2 to 3 weeks before renewed participation in the same race (second race). Blood was sampled before and at 3 and 24 hours following all exercises. Blood samples were analyzed using the same Abbot high‐sensitivity cTnI STAT assay. Fifty‐nine individuals (aged 50±9 years, 13 women) without cardiovascular disease were included. Troponin values were lowest before, highest at 3 hours, and declining at 24 hours. The largest cTnI difference was at 3 hours following exercise between the most (first race) (cTnI: 200 [87–300] ng/L) and the least strenuous exercise (cardiopulmonary exercise test) (cTnI: 12 [7–23] ng/L; P <0.001). The strongest correlation between troponin values at corresponding times was before exercise ( r =0.92, P <0.0001). The strongest correlations at 3 hours were between the 2 races ( r =0.72, P <0.001) and at 24 hours between the cardiopulmonary exercise test and the second race ( r =0.83, P <0.001). Participants with the highest or lowest cTnI levels showed no differences in race performance or baseline echocardiographic parameters. Conclusions The variation in exercise‐induced cTnI elevation is largely determined by a unique individual cTnI response that is dependent on the duration of high‐intensity exercise and the timing of cTnI sampling. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02166216 .

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

Clinical Chemistry ◽

10.1373/clinchem.2015.250811 ◽

2016 ◽

Vol 62 (4) ◽

pp. 623-630 ◽

Cited By ~ 25

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.

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