[Effect of exercise tolerance test on hemostasis in patients with and without coronary heart disease].
BACKGROUND
Physical exercise leads to an elevated coagulation activity with a possibly disturbed hemostatic balance. Therefore patients with coronary heart disease have a potentially increased risk of thromboembolic events after a bicycle exercise tolerance test, that is frequently performed for diagnostic reasons.


METHODS
Patients with angiographically known coronary heart disease (Group I: n = 49; age 59 years; male = 42, female = 7) were investigated in comparison to a healthy cohort (Group 2: n = 51; age 53 years; male = 44, female = 7) to study the influence of a standardized exercise tolerance test on hemostatic variables. Blood samples were taken before and after exercise.


RESULTS
No significant changes were found for any investigated parameter between both groups. However, 3 parameters did change significantly within the groups: factor VIII rose in Group 1 from 132 to 156% and in Group 2 from 106 to 136% and the von Willebrand factor rose in Group 1 from 230 to 249% and in Group 2 from 228 to 247%. An elevated fibrinolytic potential was found with an increase of plasminogen-alpha 2-antiplasmin in Group 1 from 251 to 401 micrograms/l and in Group 2 from 247 to 350 micrograms/l.


CONCLUSIONS
The findings underline the clinical presumption that exercise tolerance test does not increase the risk for thromboembolic complications in patients with coronary heart disease in comparison to patients without coronary heart disease, as long as the exercise tolerance test is performed in a standardized way and under aerobe conditions.
Lins
M
M
Klinik für Kardiologie, Christian-Albrechts-Universität zu Kiel. lins@cardio.uni-kiel.de
Arendt
T
T
Deutschmann
A
A
Dieszbrock
O
O
Steen
U
U
Bruhn
H D
HD
D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors / Q000378:metabolism*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood* / Q000150:complications; D005080:Exercise Test / Q000009:adverse effects*; D017079:Exercise Tolerance; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D005341:Fibrinolysin / Q000378:metabolism; D005342:Fibrinolysis; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013923:Thromboembolism / Q000209:etiology; D000979:alpha-2-Antiplasmin / Q000378:metabolism; D014841:von Willebrand Factor / Q000378:metabolism
D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; D000979:alpha-2-Antiplasmin; C037742:plasmin-plasmin inhibitor complex; D014841:von Willebrand Factor; D005169:Factor VIII; D005341:Fibrinolysin