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. 2023 Apr 11;9(2):e001488.
doi: 10.1136/bmjsem-2022-001488. eCollection 2023.

Association between engagement in exercise training and peak cardiac biomarker concentrations following ST-elevation myocardial infarction

Iris Apolonia de Koning  1 , B M A van Bakel  1 , Hajar Rotbi  1 , Robert-Jan M Van Geuns  2 , G Etienne Cramer  2 , Gheorghe A M Pop  2 , Thijs Eijsvogels  1 , Dick H J Thijssen  1   3
Affiliations

Association between engagement in exercise training and peak cardiac biomarker concentrations following ST-elevation myocardial infarction

Iris Apolonia de Koning et al. BMJ Open Sport Exerc Med. .

Abstract

Background: Regular exercise training is an important factor in prevention of myocardial infarction (MI). However, little is known whether exercise engagement prior to MI is related to the magnitude of post-MI cardiac biomarker concentrations and clinical outcomes.

Objectives: We tested the hypothesis that exercise engagement in the week prior MI is related to lower cardiac biomarker concentrations following ST-elevated MI (STEMI).

Methods: We recruited hospitalised STEMI patients and assessed the amount of exercise engagement in the 7 days preceding MI onset using a validated questionnaire. Patients were classified as 'exercise' if they performed any vigorous exercise in the week prior MI, or as 'control' if they did not. Post-MI peak concentrations of high-sensitive cardiac troponin T (peak-hs-cTnT) and creatine kinase (peak-CK) were examined. We also explored whether exercise engagement prior MI is related to the clinical course (duration of hospitalisation and incidence of in-hospital, 30-day and 6-month major adverse cardiac events (reinfarction, target vessel revascularisation, cardiogenic shock or death)).

Results: In total, 98 STEMI patients were included, of which 16% (n=16) was classified as 'exercise', and 84% (n=82) as 'control'. Post-MI peak-hs-cTnT and peak-CK concentrations were lower in the exercise group (941 (645-2925) ng/mL; 477 (346-1402) U/L, respectively) compared with controls (3136 (1553-4969) ng/mL, p=0.010; 1055 (596-2019) U/L, p=0.016, respectively). During follow-up, no significant differences were found between both groups.

Conclusion: Engagement in exercise is associated with lower cardiac biomarker peak concentrations following STEMI. These data could provide further support for the cardiovascular health benefits of exercise training.

Keywords: Cardiology physiology; Exercise; Physical activity.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flowchart of study inclusion. Flow of patients that were eligible for study inclusion (n=252) to the amount of patients that were included in the analysis (n=98) and the distribution of patients between the control and exercise group. MI, myocardial infarction; NSTEMI, non-ST elevation myocardial infarction; STEMI, ST elevation myocardial infarction.
Figure 2
Figure 2
Peak cardiac biomarker concentrations in patients diagnosed with a STEMI, in logarithmic scale. Peak cardiac biomarker concentrations in the control group (light grey) and in the exercise group (dark grey). Each dot represents a case, middle line is the median, upperline is Q3, lower line is Q1. (A) Post-MI peak concentrations of high sensitive cardiac troponin-T (ng/mL). (B) Post-MI peak concentrations of creatine kinase (U/L). MI, myocardial infarction; Peak-CK, peak creatine kinase; Peak-cTnT, peak cardiac troponin-T; STEMI, ST elevation myocardial infarction.
See this image and copyright information in PMC

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