title: The VHOT (Vindaloo Hastens Outpouring of Troponins) Study.
abstract: BACKGROUND
  Multiple cardiac and non-cardiac processes may cause an elevated highly sensitive troponin (hsTn). We postulated that the consumption of a seriously hot vindaloo could cause an increase in hsTn levels in seemingly healthy volunteers.
  
  
  OBJECTIVE
  To determine whether eating a very hot curry can cause elevated hsTn.
  
  
  METHODS
  This was a prospective observational cohort study. Participants had blood drawn for hsTn pre-ingestion and at 2 and 4 h post-ingestion of, first, a rather mild butter chicken and, 2 weeks later, a seriously hot lamb vindaloo. We assessed pre-curry tolerance and perception of curry hotness for both curries using the VHOT scale.
  
  
  RESULTS
  Although no participant had a troponin above the reference range at any point in time, we found dramatic relative increases in troponin in many of our participants. In the vindaloo phase, 8/22 (36%) had a relative change >20%, whereas 5/22 (23%) had a relative change >50% at 4 h. However, these changes were not significantly different to those in the butter chicken phase. Based on biological variability alone, 15/22 (68%) had a relative change of >20%, and 11/22 (50%) had a relative change of >50% between the two sessions (pre-ingestion).
  
  
  CONCLUSIONS
  Eating a seriously hot vindaloo does not appear to be a risk factor for troponitis, and people may consume vindaloo safely with the knowledge that this is unlikely to result in significant damage to their myocardium. However, clinicians should be aware of the biological variability of hsTn and exercise caution when interpreting apparent changes within the normal range.
authors.affiliation: Emergency Department, Coffs Harbour Base Hospital, Coffs Harbour, New South Wales, Australia.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Tankel
authors.affiliation: Emergency Department, Fiona Stanley and Geraldton Hospitals, Perth, Western Australia, Australia.
authors.forename: Yusuf
authors.identifier: http://orcid.org/0000-0003-4998-5413
authors.initials: Y
authors.lastname: Nagree
authors.affiliation: Adult Emergency Department, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Jones
authors.affiliation: Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Mountain
authors.affiliation: Emergency Department, Armadale Health Service, Nasura, Western Australia, Australia.
authors.forename: Stephen Pj
authors.initials: SP
authors.lastname: Macdonald
authors.affiliation: Emergency Department, Armadale Health Service, Nasura, Western Australia, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Hill
authors.affiliation: Emergency Medicine Department, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: Martin
authors.initials: M
authors.lastname: Than
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002212:Capsicum / Q000009:adverse effects*; D005260:Female; D005503:Food Additives / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D017365:Spices / Q000009:adverse effects*; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D005503:Food Additives; D019210:Troponin I
keywords: acute coronary syndrome; high sensitivity troponin; troponitis