title: Measurement of a plasma stroke biomarker panel and cardiac troponin T in marathon runners before and after the 2005 Boston marathon.
abstract: We report changes in cardiac troponin-T (TnT) and a new plasma stroke biomarker panel (D-dimer, B-natriuretic peptide [BNP], matrix metalloproteinase-9 [MMP-9], S-100 b, Biosite Diagnostics, San Diego, CA) in 30 nonprofessional marathon runners before and immediately after the 2005 Boston Marathon. Following competition, there was a statistically significant increase in MMP-9 (P < .001) and D dimer (P < .001). Nonsignificant changes in S-100 b and BNP were observed. Premarathon and postmarathon values for a multimarker stroke index increased from 0.97 (normal) to 3.5 (low risk or more; P < .001). Two subjects had index values more than the high-risk cutoff value. Mean TnT premarathon and postmarathon levels increased (from <0.01 to 0.03 ng/mL; P < .0001). After the marathon, with a cutoff value of 0.05 ng/mL, 7 runners (23%) had values above the manufacturer's recommended cutoff for myocardial damage. Although biochemical evidence of myocardial damage following strenuous exercise may reflect myocardial stunning or subclinical ischemia, the changes in the stroke index and values for individual stroke markers may reflect a systemic inflammatory response to exertional rhabdomyolysis which is common, but the possibility of subclinical central nervous system damage cannot be excluded.
authors.affiliation: Division of Laboratory Medicine, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Saenz
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lee-Lewandrowski
authors.forename: Malissa J
authors.initials: MJ
authors.lastname: Wood
authors.forename: Tomas G
authors.initials: TG
authors.lastname: Neilan
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Siegel
authors.forename: James L
authors.initials: JL
authors.lastname: Januzzi
authors.forename: Kent B
authors.initials: KB
authors.lastname: Lewandrowski
mesh_terms: D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000032:analysis / Q000097:blood; D008875:Middle Aged; D017682:Myocardial Stunning / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D012420:Running / Q000502:physiology*; D020521:Stroke / Q000097:blood* / Q000175:diagnosis; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T; D020780:Matrix Metalloproteinase 9