Prevalence and predictors of cardiac troponin elevations following exercise: a systematic review, meta-analysis, and meta-regression
Authors' conclusion
cTn elevations are common following exercise, most often with high-sensitivity assays and cTnT measurements, particularly in endurance sports lasting 3-6 hours.
Study context
- Population
- Athletes after exercise (78% male; mean age 44.9 years; median exercise duration 4.2 hours)
- Participants
- 7,289 athletes · 129 studies
- Outcome
- Prevalence of post-exercise cardiac troponin (cTn) elevations above the assay-specific URL
Methodological detailsrandom-effects, multilevel mixed-effects meta-regression, cubic spline models
- Random-effects
- Multilevel mixed-effects meta-regression
- Cubic spline models
Pooled result
As reported in the abstract
cTn above URL after exercise
Prevalence of cardiac troponin (cTn) above upper reference limit (URL) after exercise (95% CI 31-42%); between-study range 2-98%, extreme heterogeneity
36%
Further pooled results
Prevalence by assay sensitivity
- High-sensitivity assays
- 58%
- Non-high-sensitivity assays
- 26%
Prevalence by troponin type
- cTnT assays
- 45%
- cTnI assays
- 30%
Prevalence by sport
- Triathlon
- 49%
- Cycling
- 40%
- Running
- 41%
- Contact sports
- 6%
- Walking
- 8%
Prevalence by exercise duration
- Non-linear association; peak after 3-6 hours of exercise
- 52%
Age, sex and training status
- Higher prevalence in middle-aged individuals
- Sex and training status not associated with elevations
Original publication
Prevalence and predictors of cardiac troponin elevations following exercise: a systematic review, meta-analysis, and meta-regression. Eur J Prev Cardiol. Published 15 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it