Biochemia Medica, Vol. 21 No. 1, 2011.
Review article
Cardiac troponins and physical exercise. It’s time to make a point
Giuseppe Lippi
orcid.org/0000-0001-9523-9054
; U.O. Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma, Italy
Gianfranco Cervellin
; U.O. Pronto Soccorso e Medicina d’Urgenza, Dipartimento di Emergenza-Urgenza, Azienda Ospedaliero-Universitaria di Parma, Italy
Giuseppe Banfi
; Istituto Galeazzi e Università di Milano, Italy
Mario Plebani
; Dipartimento di Medicina di Laboraotorio, Azienda Ospedaliero-Universitaria di Padova and Leonardo Foundation, Abano Terme (PD), Italy
Abstract
The timely diagnosis of acute coronary syndrome (ACS), in particular myocardial infarction (MI), is still one of the most challenging issues in medicine. The introduction into routine laboratory practice of assays for measuring the cardiospecific troponins has dramatically revolutionized the diagnostic ap-proach and the recent development of methods with improved analytical sensibility (i.e., highly sensitivity [HS] assays), has further contributed to improve the negative predictive value of troponin testing but, contextually, has substantially lowered the clinical specificity of these markers. In particu-lar, clinical studies have demonstrated the existence of an exercise-related increase of HS-troponins, with measurable values detectable in up to 94% of athletes undergoing endurance sports. This mea-surable amount of troponin in blood would mirror an increased membrane permeability and early tro-ponin release rather than reflecting a clinically threatening myocardial injury. As such, the measurable amount of cardiac troponins as assessed with the novel HS assays requires major clinical focus (i.e., serial measurement of cardiac biomarkers, detailed clinical history-taking, integration with ECG and imaging findings) to prevent misdiagnosis of ACS and/or MI in otherwise healthy persons.
Keywords
sports; biomarkers; acute myocardial infarction; cardiac injury; troponin
Hrčak ID:
64501
URI
Publication date:
15.2.2011.
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