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High-sensitivity troponin in marathon runners

To the Editor: In 2009, we reported on increases in the level of cardiac troponin (using the TnI-Ultra troponin I assay [Siemens Healthcare Diagnostics]) among runners in the Perth marathon.1 Of the 88 runners enrolled, raised troponin levels were seen in 28 participants (32%). The independent predictors were weight loss and an increase in creatinine levels.

Recently, high-sensitivity fifth-generation troponin assays have become available for evaluation pending United States Food and Drug Administration approval. After obtaining approval from the Royal Perth Hospital ethics committee, stored blood samples were reanalysed to compare with our original results. The assay used was the Architect STAT High Sensitive Troponin-I (Abbott Diagnostics). The sex-specific cut-points supplied by the manufacturer for the assay were 16 ng/L for females and 34 ng/L for males.

In repeating our original analysis, we found that 70 (80%) had an elevated troponin level, similar to the findings of another study using the hs-cTnT assay, in which 86% of runners had a raised troponin level.2 Repetition of the statistical model used in our original study revealed no variable that was predictive of an elevated troponin…