title: The effect of exercise on coagulation and fibrinolysis factors in patients with peripheral arterial disease.
abstract: Peripheral arterial disease is a widely prevalent atherosclerotic occlusive disorder. Symptoms commence with exercise-induced pain in the lower extremities, known as claudication. Despite the fact that exercise has been shown to improve fibrinolytic profile some patients, the effect of exercise on coagulation and fibrinolysis cascades in claudicants has not been comprehensively defined. Literature search in English language yielded 13 studies of exercise on claudicants, including 420 patients. Claudicants tend to have a higher coagulation activity at rest compared to healthy individuals, a trend that persists even after exercise. Post-exercise coagulation activity of claudicants is increased when compared to their respective baseline levels, but it is so in a non-consistent manner. From the available data, it has been suggested that claudicants have a functional and effective fibrinolytic mechanism in place, operating continuously at a relatively higher activity level compared to healthy individuals. Fibrinolysis seems to be activated by exercise; a positive outcome with a prolonged effect as shown by a few of the studies. A final conclusion whether coagulation or fibrinolysis activity is affected mostly by exercise type and intensity in claudicants could not be answered. All conclusions regarding the effect of exercise on the coagulation and fibrinolysis mechanisms should be taken under cautious consideration, due to the limited number of studies, the small number of patients and the different exercise strategies employed in each study. Further randomized studies with similar exercise protocols could provide safer conclusions in the future.
authors.affiliation: First Department of Surgery, Vascular Unit, Laiko General Hospital, National & Kapodistrian University of Athens, 11527 Athens, Greece patelisn@gmail.com.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Patelis
authors.affiliation: First Department of Surgery, Vascular Unit, Laiko General Hospital, National & Kapodistrian University of Athens, 11527 Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Karaolanis
authors.affiliation: Vascular Unit, General University Hospital of Thessaly, 41110 Larisa, Greece.
authors.forename: Georgios N
authors.initials: GN
authors.lastname: Kouvelos
authors.affiliation: Department of General Surgery, Royal Free Hospital, NW3 2QG London, UK.
authors.forename: Collin
authors.initials: C
authors.lastname: Hart
authors.affiliation: Vascular Unit, Royal Free Hospital, NW3 2QG London, UK.
authors.forename: Sean
authors.initials: S
authors.lastname: Metheiken
mesh_terms: D001777:Blood Coagulation / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D058729:Peripheral Arterial Disease / Q000097:blood / Q000503:physiopathology*
keywords: Arteries; claudicants; coagulation; exercise; fibrinolysis; peripheral arterial disease