title: Effects of acute exercise on fibrinolysis and coagulation in patients with coronary artery disease.
abstract: Acute physical exertion may trigger an acute coronary syndrome. Furthermore, acute physical exercise may influence hemostatic markers in healthy individuals. However, the effect of acute exercise on blood fibrinolysis and coagulation in patients with coronary artery disease (CAD) is still not well understood. Nineteen untrained patients with angiographically proven CAD (age, 58 +/- 9 years, 12 males), and 25 age- and sex-matched controls without CAD (age, 56 +/- 6 years, 16 males) underwent a treadmill exercise test. Global fibrinolytic capacity (GFC) and prothrombin fragment 1 + 2 (F 1 + 2) levels were measured before exercise, at peak exercise, and 2 hours after recovery. There were no differences between the groups with respect to left ventricular ejection fraction, history of hypertension, body mass index, and serum lipids. Before exercise, GFC was significantly lower in patients with CAD when compared with controls (1.40 +/- 0.43 versus 3.28 +/- 1.19 microg/mL, respectively; P < 0.001). In patients with CAD, F 1 + 2 levels were significantly higher than those of controls (1.15 +/- 0.43 versus 0.79 +/- 0.10 nmol/L, respectively; P = 0.002). In both study groups, GFC levels increased significantly at peak exercise and decreased to baseline values 2 hours after recovery. At peak exercise, F 1 + 2 levels significantly increased in both study groups. However, while F 1 + 2 levels of controls decreased to baseline values 2 hours after recovery (0.79 +/- 0.10 versus 0.80 +/- 0.10 nmol/L; P > 0.05), F 1 + 2 levels of patients with CAD were still significantly elevated (1.15 +/- 0.43 versus 1.84 +/- 0.06 nmol/L; P = 0.002). Acute exercise increases coagulation and fibrinolysis both in untrained subjects with and without CAD. However, in patients with CAD, the equilibrium between fibrinolysis and coagulation during peak exercise is disturbed in favor of coagulation after recovery.
authors.affiliation: Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Acil
authors.forename: Enver
authors.initials: E
authors.lastname: Atalar
authors.forename: Levent
authors.initials: L
authors.lastname: Sahiner
authors.forename: Baris
authors.initials: B
authors.lastname: Kaya
authors.forename: Ibrahim C
authors.initials: IC
authors.lastname: Haznedaroglu
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgozoglu
authors.forename: Kenan
authors.initials: K
authors.lastname: Ovunc
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Necla
authors.initials: N
authors.lastname: Ozer
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
authors.forename: Ferhan
authors.initials: F
authors.lastname: Ozmen
authors.forename: Nasih
authors.initials: N
authors.lastname: Nazli
authors.forename: Sirri
authors.initials: S
authors.lastname: Kes
authors.forename: Serdar
authors.initials: S
authors.lastname: Aksoyek
mesh_terms: D000372:Agglutination Tests; D001777:Blood Coagulation / Q000502:physiology*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D004452:Echocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011516:Prothrombin; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D010446:Peptide Fragments; C045879:prothrombin fragment 1.2; D011516:Prothrombin