Effect of exercise intensity and duration on cardiac troponin release

The latest generation of high-sensitivity cardiac troponin assays are able to quantify very low concentrations of troponin in the majority of people. Indeed, international guidelines now recommend the use of low concentrations of troponin to risk-stratify patients with suspected acute coronary syndrome.¹ Furthermore, troponin is an independent predictor of cardiovascular events in apparently healthy populations, and therefore, concentrations within the reference range may have a wider role in guiding the use of preventative therapies.² However, troponin can become significantly elevated after physical exercise. Interpreting troponin concentrations in this context is challenging because the kinetics of troponin release after physical exercise are not well understood. Most previous research has used assays that are not able to quantify troponin within the reference range, or has involved endurance athletes and evaluated a single time point rather than serial sampling.³