{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:06:16Z","timestamp":1793412376432,"version":"4.5.0"},"reference-count":62,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"South Eastern Norway Regional Health Authorities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007793","name":"Stiftelsen Kristian Gerhard Jebsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007793","id-type":"DOI","asserted-by":"publisher"}]},{"name":"K.G. Jebsen Center for Cardiac Biomarkers","award":["SKGJ-MED-024"],"award-info":[{"award-number":["SKGJ-MED-024"]}]},{"DOI":"10.13039\/501100006209","name":"Radboud University Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006209","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Academic Alliance Fund"},{"name":"Established Investigator E-Dekker","award":["#03-002-2023-0036"],"award-info":[{"award-number":["#03-002-2023-0036"]}]},{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"crossref"}]},{"name":"FIT-HEART consortium","award":["#01-001-2024-0621"],"award-info":[{"award-number":["#01-001-2024-0621"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Myocardial injury is defined by cardiac troponin (cTn) elevations exceeding the upper reference limit (URL) and serves as a diagnostic criterion for myocardial infarction. However, exercise can also elevate cTn, complicating interpretation. We aimed to determine the prevalence and predictors of cTn elevations following exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a random-effects meta-analysis of post-exercise cTn elevations above the assay-specific URL. Associations between prespecified covariates and the prevalence of elevated post-exercise cTn were assessed using multilevel mixed-effects meta-regression and cubic spline models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 4315 articles and included 129. The cohort consisted of 7289 athletes (78% male; mean age 44.9 years; median exercise duration 4.2\u2005h). Overall, 36% (95% CI 31\u201342%) of athletes demonstrated cTn concentrations above the URL following exercise, with extreme between-study heterogeneity (range 2\u201398%). The prevalence was higher with high-sensitivity vs. non-high-sensitivity assays (58% vs. 26%) and cTnT vs. cTnI assays (45% vs. 30%) and in middle-aged individuals. Sex and training status were not associated with elevations. Endurance sports, including triathlon (49%), cycling (40%), and running (41%), showed the highest prevalence, while contact sports (6%) and walking (8%) showed the lowest. The prevalence was non-linearly associated with exercise duration, with a peak (52%) after 3\u20136\u2005h of exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>cTn elevations are common following exercise, most often with high-sensitivity assays and cTnT measurements, particularly in endurance sports lasting 3\u20136\u2005h. Clinicians should consider assay type and exercise characteristics rather than sex and training status when evaluating post-exercise cTn elevations in athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42023384920<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag218","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T11:25:23Z","timestamp":1776079523000},"source":"Crossref","is-referenced-by-count":4,"title":["Prevalence and predictors of cardiac troponin elevations following exercise: a systematic review, meta-analysis, and meta-regression"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3689-5710","authenticated-orcid":false,"given":"Jesse O","family":"Stekelenburg","sequence":"first","affiliation":[{"name":"Department of Medical BioSciences, Exercise Physiology Research Group, Radboud University Medical Center , P.O. Box 9101, Nijmegen 6500 HB ,","place":["The Netherlands"]},{"name":"Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology , Trondheim ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4494-376X","authenticated-orcid":false,"given":"Kristian","family":"Berge","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital , L\u00f8renskog ,","place":["Norway"]},{"name":"K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3950-0523","authenticated-orcid":false,"given":"Sylvan L J E","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Medical BioSciences, Exercise Physiology Research Group, Radboud University Medical Center , P.O. Box 9101, Nijmegen 6500 HB ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6452-0369","authenticated-orcid":false,"given":"Torbj\u00f8rn","family":"Omland","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital , L\u00f8renskog ,","place":["Norway"]},{"name":"K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5871-1804","authenticated-orcid":false,"given":"Peder L","family":"Myhre","sequence":"additional","affiliation":[{"name":"K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo , Oslo ,","place":["Norway"]},{"name":"Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0365-2149","authenticated-orcid":false,"given":"Paul D","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hartford Hospital , Hartford, CT ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8722-6739","authenticated-orcid":false,"given":"Vincent L","family":"Aengevaeren","sequence":"additional","affiliation":[{"name":"Department of Medical BioSciences, Exercise Physiology Research Group, Radboud University Medical Center , P.O. Box 9101, Nijmegen 6500 HB ,","place":["The Netherlands"]},{"name":"Department of Cardiology, Radboud University Medical Center , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0747-4471","authenticated-orcid":false,"given":"Thijs M H","family":"Eijsvogels","sequence":"additional","affiliation":[{"name":"Department of Medical BioSciences, Exercise Physiology Research Group, Radboud University Medical Center , P.O. 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