TY - JOUR
T1 - Cardiac troponin concentrations following exercise and the association with cardiovascular disease and outcomes
T2 - rationale and design of the prospective TREAT cohort study
AU - Janssen, Sylvan L. J. E.
AU - Lamers, Sacha K.
AU - Vroemen, Wim H. M.
AU - Denessen, Ellen J. S.
AU - Berge, Kristian
AU - Bekers, Otto
AU - Hopman, Maria T. E.
AU - Brink, Monique
AU - Habets, Jesse
AU - Nijveldt, Robin
AU - Van Everdingen, Wouter M.
AU - Aengevaeren, Vincent L.
AU - Mingels, Alma M. A.
AU - Eijsvogels, Thijs M. H.
PY - 2024/6/1
Y1 - 2024/6/1
N2 - Exercise can produce transient elevations of cardiac troponin (cTn) concentrations, which may resemble the cTn release profile of myocardial infarction. Consequently, clinical interpretation of postexercise cTn elevations (ie, values above the 99th percentile upper reference limit) remains challenging and may cause clinical confusion. Therefore, insight into the physiological versus pathological nature of postexercise cTn concentrations is warranted. We aim to (1) establish resting and postexercise reference values for recreational athletes engaged in walking, cycling or running exercise; (2) compare the prevalence of (sub)clinical coronary artery disease in athletes with high versus low postexercise cTn concentrations and (3) determine the association between postexercise cTn concentrations and the incidence of major adverse cardiovascular events (MACE) and mortality during long-term follow-up. For this purpose, the prospective TRoponin concentrations following Exercise and the Association with cardiovascular ouTcomes (TREAT) observational cohort study was designed to recruit 1500 recreational athletes aged >= 40 to <70 years who will participate in Dutch walking, cycling and running events. Baseline and postexercise high-sensitivity cTnT and cTnI concentrations will be determined. The prevalence and magnitude of coronary atherosclerosis on computed tomography (eg, coronary artery calcium score, plaque type, stenosis degree and CT-derived fractional flow reserve) will be compared between n=100 athletes with high postexercise cTn concentrations vs n=50 age-matched, sex-matched and sport type-matched athletes with low postexercise cTn concentrations. The incidence of MACE and mortality will be assessed in the entire cohort up to 20 years follow-up. The TREAT study will advance our understanding of the clinical significance of exercise-induced cTn elevations in middle-aged and older recreational athletes. Trial registration number NCT06295081.
AB - Exercise can produce transient elevations of cardiac troponin (cTn) concentrations, which may resemble the cTn release profile of myocardial infarction. Consequently, clinical interpretation of postexercise cTn elevations (ie, values above the 99th percentile upper reference limit) remains challenging and may cause clinical confusion. Therefore, insight into the physiological versus pathological nature of postexercise cTn concentrations is warranted. We aim to (1) establish resting and postexercise reference values for recreational athletes engaged in walking, cycling or running exercise; (2) compare the prevalence of (sub)clinical coronary artery disease in athletes with high versus low postexercise cTn concentrations and (3) determine the association between postexercise cTn concentrations and the incidence of major adverse cardiovascular events (MACE) and mortality during long-term follow-up. For this purpose, the prospective TRoponin concentrations following Exercise and the Association with cardiovascular ouTcomes (TREAT) observational cohort study was designed to recruit 1500 recreational athletes aged >= 40 to <70 years who will participate in Dutch walking, cycling and running events. Baseline and postexercise high-sensitivity cTnT and cTnI concentrations will be determined. The prevalence and magnitude of coronary atherosclerosis on computed tomography (eg, coronary artery calcium score, plaque type, stenosis degree and CT-derived fractional flow reserve) will be compared between n=100 athletes with high postexercise cTn concentrations vs n=50 age-matched, sex-matched and sport type-matched athletes with low postexercise cTn concentrations. The incidence of MACE and mortality will be assessed in the entire cohort up to 20 years follow-up. The TREAT study will advance our understanding of the clinical significance of exercise-induced cTn elevations in middle-aged and older recreational athletes. Trial registration number NCT06295081.
KW - Exercise
KW - Radiology
KW - Cardiovascular
KW - Cardiology
KW - Heart disease
KW - FRACTIONAL FLOW RESERVE
KW - MYOCARDIAL-INFARCTION
KW - COMPUTED-TOMOGRAPHY
KW - CT
KW - ANGIOGRAPHY
KW - POPULATION
KW - EQUATION
U2 - 10.1136/bmjsem-2024-002070
DO - 10.1136/bmjsem-2024-002070
M3 - Article
SN - 2055-7647
VL - 10
JO - BJM Open Sport & Exercise Medicine
JF - BJM Open Sport & Exercise Medicine
IS - 2
M1 - e002070
ER -