Key Facts
- STUDY TYPE: Prospective Observational Study
- FIELD: Sports Cardiology
- STATUS: Planning
- START: July 2026
- PARTICIPANTS: Athletes participating at the X-Trails Davos in Summer 2026
Background and Rationale
Understanding Elevated Troponin in Athletes: The Role of Macrotroponin
Cardiac troponin is a well-established biomarker used to diagnose acute myocardial infarction, but elevated levels are also seen in other conditions such as myocarditis. A confirmed diagnosis typically requires a 3–6 month break from sport. However, symptoms are often unclear, and elevated high-sensitivity cardiac troponin frequently leads to costly imaging tests such as echocardiography and cardiac magnetic resonance imaging (MRI), even when there are no clear signs of myocarditis.
False-Positive Results
Emerging research suggests falsely elevated troponin levels may result from macrotroponin, formed when troponin binds anti-troponin antibodies during immune responses. In athletes, interpretation is harder, as endurance exercise alone can temporarily raise troponin levels above the upper reference limit. The prevalence of macrotroponin in athletic populations remains unknown, highlighting an important gap in sports cardiology research.
Study Objectives
The primary objective is to determine the prevalence of macrotroponin in athletes. In addition, the study will assess whether macrotroponin levels increase following physical exertion and whether responses differ across endurance sports, including ultra marathon, marathon, half marathon, and quarter marathon participants. By singleing falsely elevated troponin with targeted lab tests, this project aims to reduce unnecessary diagnostic procedures, avoid non- essential training breaks, and support evidence- based decisions in sports cardiology.