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Prolonged exercise should be considered alongside typical symptoms of acute myocardial infarction when evaluating increases in cardiac troponin T
  1. R E Shave1,
  2. G P Whyte2,
  3. K George3,
  4. D C Gaze4,
  5. P O Collinson4
  1. 1Brunel University, Uxbridge, Middlesex, UK
  2. 2Olympic Medical Institute, Northwick Park Hospital, Harrow, Middlesex, UK
  3. 3Liverpool John Moores University, Liverpool, UK
  4. 4St Georges Healthcare NHS Trust, Tooting, London, UK
  1. Correspondence to:
    Dr Robert E Shave
    Brunel University, Uxbridge, Middlesex UB8 3PH, UK;

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Following the recommendations of the European Society of Cardiology and the American College of Cardiology in 2000, cardiac troponins T (cTnT) and I are now integral to the diagnosis of non-ST elevation myocardial infarction. Although discussion is ongoing regarding the appropriate cut off for cTnT,1 the use of cTnT in the diagnosis of acute myocardial infarction (AMI) has greatly enhanced diagnostic sensitivity and further improved risk stratification. Cardiac troponin determinations are not required for diagnosis or treatment of classic ST segment elevation myocardial infarction, as thrombolysis is administered solely on the basis of ECG criteria. It is noteworthy, however, that within a clinical population any rise in cTnT above the detection limit of the assay is related to an increased risk of death.2 Recent studies of highly trained endurance athletes completing ultra-endurance exercise have reported isolated increases of cardiac troponins in the absence of acute coronary symptoms.3 To date, only limited investigation has examined cTnT after more readily accessible and increasingly popular events such as the London Marathon in less well trained people. Accordingly, we investigated the impact of running the London Marathon on circulating cTnT in a heterogeneous cohort of non-elite runners.


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  • Competing interest statement: All authors declare that there is no competing interest and therefore have nothing to declare.

  • We acknowledge the support of Cardiac Risk in the Young.