Marathon Run III: Effects on Coagulation, Fibrinolysis, Platelet Aggregation and Serum Cortisol Levels

Abstract

SummaryBlood coagulation, fibrinolysis, platelet count-aggregation and Cortisol were assessed in 35 Finnish amateur runners aged 27 to 56 years (mean 40) and three aged 65, 67, and 82 who had run a non-competitive Marathon in 1975, 1976 and 1977 over the classical itinerary. After the run, in all 3 years, APTT showed shortening (p < 0.001); prothrombin time and plasma fibrinogen were not significantly altered; euglobulin lysis time was shorter (p < 0.001) and FDP increased (p < 0.001); PSPT became positive in all subjects, whereas the ethanol gelation test remained negative; no cryofibrinogen was detected. Platelet count and aggregation showed increase (p < 0.001) in 1975 (extreme heat, 25° C) but remained unaltered in 1976, 1977 (15–18° C). Cortisol levels were always significantly increased – more markedly in 1975. Women’s responses were similar to those of men. A possible correlation between physical fitness and the responses of haemostatic balance is suggested and the influence of weather is discussed.

Effects of Marathon Running on Platelet Activation Markers

“…12,13 Rock and colleagues 15 reported that 24 hours after participation in a marathon, platelet aggregation in response to epinephrine, ADP, and collagen was decreased, indicating activation during the period of exercise. Similarly, Knudsen and coworkers 14 reported decreases in ADP-induced platelet "aggregability" and decreased serotonin release induced by ADP and collagen after long-distance running, consistent with exhaustion of platelet aggregation capacity.…”

“…2,[5][6][7][8][9] In the majority of studies, platelet counts were elevated and there was evidence of platelet activation following prolonged exertion. [10][11][12][13][14][15] Many of the investigations focusing on platelets measured in vitro platelet aggregation or soluble factors correlated with platelet activation; such studies are labor-intensive and require highly trained personnel and specialized equipment, limiting their availability in many settings, and provide only indirect evidence of in vivo platelet activation.…”

Effects of strenuous exercise on haemostasis: Table 1

“…The activation of these systems is less pronounced in athletes than untrained runners. 38 In healthy subjects, the activation of the cascades should work to maintain the balance between the two systems, 16 38 47 but if the activation of these systems is not in balance, a predisposition to thrombus formation may be the result. In a group of patients followed up for one hour after exercise, Hegde et al 17 found that, although t-PA antigen level declined gradually over the hour, activated partial thromboplastin time remained shortened, suggesting continued activation of coagulation.…”

“…18 The cascade also has its own regulatory proteins that inhibit coagulation at various stages, such as antithrombin III and protein C. These inhibitors of coagulation are also affected by exercise, although the results of studies looking at this are not so conclusive. Antithrombin III has been shown to fall in one study, 38 although little change was seen in others. 13 14 Ferguson et al 12 describe a rise in absolute antithrombin III concentration, but a fall in concentration once corrections were made for plasma volume, suggesting consumption of the factors.…”

Upright posture and maximal exercise increase platelet aggregability and prostacyclin production in healthy male subjects.

“…5 The eVect of exercise on platelet aggregability remains uncertain, with reports indicating an increase, [6][7][8][9][10][11][12] no change, [13][14][15][16] or even a decrease 17 in platelet reactivity. The eVect of exercise on platelet adhesion is also poorly defined, in part because of the use of methodology that could not reliably distinguish platelet adhesion from aggregation in those studies.…”