Impact of exercise training on inflammation and platelet activation in patients with intermittent claudication.
BACKGROUND
Serum markers of inflammation and platelet activation are related to cardiovascular risk. Cardiovascular risk reduction is a major treatment goal in patients with peripheral arterial disease (PAD). Although current guidelines recommend supervised exercise training (SET) for PAD patients with intermittent claudication, its contribution to risk reduction remains unclear. Aim of the present study was to assess the impact of SET on inflammation and platelet activation as surrogates for cardiovascular risk.


METHODS
Fifty-three patients with intermittent claudication were randomly assigned to SET on top of best medical treatment (BMT) for 6 months (SET-group) or to BMT only (BMT-group). High sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and fibrinogen as well as soluble P-selectin (sP-sel), prothrombin fragment 1+2 (F1.2) and monocyte-platelet aggregates (MPA) were determined at study entry, after 3, 6 and 12 months.


RESULTS
While clinical improvement, reflected by an increase of walking capacity, was observed upon SET, no lasting changes of markers of inflammation and platelet activation were found within the SET-group during the training period. Compared to the BMT-group no improvements of these markers were observed in response to training at any time point (all p >0.05).


CONCLUSIONS
Regular SET added no further anti-inflammatory effect and had no effect on platelet activation when provided on top of BMT in PAD patients with intermittent claudication.
Division of Angiology, Department of Medicine II, Medical University of Vienna, Austria. oliver.schlager@meduniwien.ac.at
Oliver
O
Schlager
Alexandra
A
Hammer
Aura
A
Giurgea
Othmar
O
Schuhfried
Veronika
V
Fialka-Moser
Michael
M
Gschwandtner
Renate
R
Koppensteiner
Sabine
S
Steiner
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets / Q000502:physiology*; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood; D002449:Cell Aggregation; D008078:Cholesterol, LDL / Q000097:blood; D005081:Exercise Therapy; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D007383:Intermittent Claudication / Q000097:blood* / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000502:physiology; D019007:P-Selectin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000150:complications / Q000628:therapy*; D011516:Prothrombin; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016138:Walking
D015415:Biomarkers; D002097:C-Reactive Protein; D008078:Cholesterol, LDL; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D007375:Interleukin-1; D019007:P-Selectin; D010446:Peptide Fragments; D011516:Prothrombin; C517652:hemoglobin A1c protein, human; C045879:prothrombin fragment 1.2