Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis

Background: Kinetics, moderators and reference limits for exercise-induced cardiac troponin T (cTnT) elevations are still unclear. Methods: A systematic review of published literature was conducted adhering to the Preferred Reporting Items Systematic Review Meta-Analyses (PRISMA) guidelines. Studies reporting high-sensitivity (hs-cTnT) concentrations before after a bout exercise in athletes were included analyzed. The final dataset consisted 62 estimates from 16 bouts 13 studies 5–1,002 (1,421 total). Meta-analysis performed using general linear mixed modeling Bayesian inferences about effect magnitudes. Modifying fixed-effect gender, age, baseline level, duration, intensity modalities investigated. Simulation used derive 99th percentile with 95% upper ranges hs-cTnT athletic populations. Results: mean 4.4 19 ng.L ?1 . Clear increases ranging large very (factor changes 2.1–7.5, 90% compatibility limits, ×/÷1.3) evident 0.7 through 25 h, peaking at 2.9 h midpoint 2.5-h running, when limit 33 390 ng L four-fold increase duration produced clear (2.4, ×/÷1.7) post-exercise hs-cTnT. Rowing demonstrated an extremely reduction (0.1 ×/÷2.4). Conclusions: kinetics cTnT elevation following exercise, positive impact modality populations reasonably well defined by this meta-analysis.