Cardiac biomarkers, electrolytes, and other analytes in collapsed marathon runners: implications for the evaluation of runners following competition.


Journal Article

We measured analytes in collapsed Boston Marathon runners to compare with changes in asymptomatic runners. Of collapsed runners at the 2007 marathon, 18.2% had a measurable cardiac troponin T (cTnT) value with a mean postrace level of 0.017 ng/mL (0.017 microg/L; SD, 0.02 ng/mL [0.02 microg/L]). Three subjects had cTnT values above the cutoff (0.10 ng/mL [0.10 microg/L]) typically used for the diagnosis of acute myocardial infarction. The mean and median N-terminal pro-B-type natriuretic peptide levels were 73 ng/L (SD, 77.3 ng/L) and 54.3 ng/L (interquartile range, 22.8-87.3 ng/L), respectively, in collapsed runners. Only 4.9% had values more than the age-specific normal value (<125 ng/L for subjects younger than 75 years). In collapsed subjects at the 2006 marathon, 18.0% had an abnormal sodium value, including 18 cases of hypernatremia and 7 cases of hyponatremia. The ionized calcium level was low in 49% of subjects, and the ionized magnesium level was low in 19.5% and elevated in 1 subject. The blood lactate level was elevated in 95% of subjects. The frequency of elevated postrace cTnT levels in collapsed athletes after endurance exercise is similar to that in asymptomatic runners. Other metabolic abnormalities, including hypernatremia, hyponatremia, low ionized calcium and magnesium levels, and lactic acidosis may contribute to muscle fatigue and collapse.

Full Text

Duke Authors

Cited Authors

  • Siegel, AJ; Januzzi, J; Sluss, P; Lee-Lewandrowski, E; Wood, M; Shirey, T; Lewandrowski, KB

Published Date

  • June 2008

Published In

Volume / Issue

  • 129 / 6

Start / End Page

  • 948 - 951

PubMed ID

  • 18480012

Pubmed Central ID

  • 18480012

Electronic International Standard Serial Number (EISSN)

  • 1943-7722

International Standard Serial Number (ISSN)

  • 0002-9173

Digital Object Identifier (DOI)

  • 10.1309/4l0m60mgaqbchmv7


  • eng