What is the clinical relevance of exercise induced increases in cardiac troponin levels on survival and cardiovascular incidents?

Exercise-induced cardiac troponin elevations are frequently observed in athletes. The clinical relevance of this phenomenon is currently unknown. This study aims to determine the predictive capacity of exercise-induced cTn elevations for future cardiovascular events and mortality. Therefore we will include 500 participants in this trial and adopt a 5-year follow-up design. Data regarding the incidence of cardiovascular diseases, cardiovascular incidents and mortality (all-cause and CVD specific) will be collected annually.

Baseline resting levels of cardiac troponin have been shown to be a predictor fur future cardiovascular events and mortality. We hypothesize that the exercise induced increases in cardiac troponins may be a superior predictor for survival and CVD events.

There will be an annual follow-up regarding the health status of each subject.

To study the 5-year predictive power of exercise-induced cTn elevations, I will adopt a semi-prospective follow-up design. Data regarding the incidence of cardiovascular diseases, cardiovascular incidents and mortality (all-cause and CVD specific) will be collected annually. Subjects that successfully completed the first day of the Nijmegen Four Days Marches will be eligible for inclusion. Blood samples are collected pre and post exercise and high sensitivity cardiac troponin I levels are determined accordingly. The incidence of cardiovascular events is scored with the ICD-10 I00-99 classifications using a validated internet based questionnaire (SNAP software). Furthermore, national registers will be used to determine survival/mortality status of participants.