Completing an extreme triathlon significantly increased median cTnI (3 to 69 ng/L), cTnT (6 to 40 ng/L), and the cTnI/cTnT ratio (0.5 to 2.1) immediately post-race (all p<0.001).
Observational (n=93)
Does completing a long-distance triathlon alter serum concentrations of cTnI, cTnT, and the cTnI/cTnT ratio in adult triathletes?
Serum concentrations of cTnI, cTnT, and their ratio increase immediately after a long-distance triathlon and trend toward normalization the next day, highlighting the need to interpret post-exercise troponin elevations carefully.
p-value: p=<0.001
Objective Cardiac troponins (cTns) are frequently measured in patients when suspecting coronary artery disease (CAD). However, recent studies suggest that elevated cTns following exercise may predict CAD and increased mortality. Although the mechanisms underlying postexercise cTn increase remain unclear, the cardiac troponin I (cTnI)/cardiac troponin T (cTnT) ratio shows promise for distinguishing cardiac pathologies. This study assesses the dynamics of cTnI and cTnT concentrations and the cTnI/cTnT ratio in serum samples collected 1–2 days before, within 1 hour after and 11–24 hour after completing Norseman Xtreme Triathlon. Methods Using Abbott’s STAT High Sensitive Troponin-I assay and Roche’s Elecsys Troponin T hs assay, we measured cTnI and cTnT in venous serum of 93 adult triathletes. Results Concentrations of cTnI, cTnT and cTnI/cTnT ratio increased from baseline to immediately after the race (cTnI median (25–75 percentile) from (3 (2–6) ng/L) to 69 (37–156) ng/L, cTnT from (6 (5–8) ng/L) to 40 (24–55) ng/L and cTnI/cTnT from (0.5 (0.3–0.8)) to 2.1 (1.5–2.9), all p<0.001). Serum cTnI and cTnT concentrations remained elevated the day after the race, whereas the cTnI/cTnT ratio declined the day after the race compared with baseline levels. Three participants displayed higher cTnI levels, and 14 participants showed higher cTnI/cTnT ratios the day after the race compared with immediately after. Conclusion Serum concentrations of cTnI, cTnT and the cTnI/cTnT ratio increase immediately after a long-distance triathlon, and concentrations trend towards normalisation the next day. The clinical implications are unknown and warrant further investigation.
Bonnevie-Svendsen et al. (2026) conducted an observational in Healthy adult triathletes (n=93). Norseman Xtreme Triathlon (extreme exercise) vs. Baseline (1-2 days pre-race) was evaluated on Dynamics of cTnI and cTnT concentrations and the cTnI/cTnT ratio (p=<0.001). Completing an extreme triathlon significantly increased median cTnI (3 to 69 ng/L), cTnT (6 to 40 ng/L), and the cTnI/cTnT ratio (0.5 to 2.1) immediately post-race (all p<0.001).