Physical exercise and hemostasis

Abstract

A number of hemostatic changes involving platelets, coagulation and fibrinolysis have been reported after acute physical exercise. Results have sometimes been controversial, due to differences in subjects investigated, type of exercise and methods used for hemostatic evaluation. On the whole, physical exercise has been shown to induce: (1) increases in platelet number and activity, (2) activation of coagulation leading to a slight but significant thrombin generation and (3) activation of fibrinolysis. These changes are short lasting. Less known are hemostatic changes induced by exercise training programs: a few data are available on the effects on platelets and coagulation, whereas studies performed on fibrinolysis show a decrease in plasminogen activator inhibitor-1 levels at rest and an increase in fibrinolytic capacity after training.

Exercise and Physical Activity

“…119 For example, acute exercise increases some clotting factors (particularly factor VIII and von Willebrand factor), and this has been associated with a reduction in clotting time, but it is unclear whether this leads to significant thrombin generation and/or fibrin formation. 120,121 Many of these changes disappear quickly during recovery from exercise, although other factors may take as long as 48 hours to return to baseline levels. 122 There is considerable interindividual variability in the response to acute exercise, and these responses are dependent on exercise intensity, suppressed by ␤-blockade, enhanced by catecholamine responses, and more pronounced among patients with coronary artery disease.…”

“…122 There is considerable interindividual variability in the response to acute exercise, and these responses are dependent on exercise intensity, suppressed by ␤-blockade, enhanced by catecholamine responses, and more pronounced among patients with coronary artery disease. 118,119,121 In contrast to acute exercise, both higher physical activity patterns and structured exercise programs have an inhibitory effect on thrombogenic factors and enhance blood fibrinolytic potential. 119,[123][124][125][126][127] These changes have been demonstrated in both healthy subjects and patients with cardiovascular disease and occur across a broad range of factors involved in the coagulation cascade.…”

“…119 On sait, par exemple, que ces derniers augmentent les taux de certains facteurs de la coagulation (dont les facteurs VIII et Willebrand), réduisant par là même le temps de coagulation, mais il n'est pas clairement établi que cela se traduise par une production significative de thrombine et/ou de fibrine. 120,121 Nombre de ces anomalies se normalisent rapidement pendant la phase de récupération qui fait suite à l'effort physique, bien que les taux de certains facteurs puissent mettre jusqu'à 48 heures avant de revenir à leur niveau initial. 122 Les effets d'un effort aigu varient considérablement selon les individus ; de plus, ils dépendent de l'intensité de l'effort, sont inhibés par les bêta-bloquants, augmentés par les réponses catécholaminergiques et majorés chez les patients coronariens.…”

“…122 Les effets d'un effort aigu varient considérablement selon les individus ; de plus, ils dépendent de l'intensité de l'effort, sont inhibés par les bêta-bloquants, augmentés par les réponses catécholaminergiques et majorés chez les patients coronariens. 118,119,121 Contrairement aux efforts aigus, les activités physiques plus soutenues et les programmes d'entraînement structuré ont un…”

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“…During coagulation, fibrinogen is converted to fibrin by means of thrombin and ionized calcium. The exercise contributes partly to this coagulation activation leading to a small but significant thrombin generation and activation of fibrinolysis (Mavrovouniotis, 2012;Prisco et al, 1994). Kumar, Kar and Fay (2011) and Wosornu et al (1992) concluded that aerobic exercise following a coronary bypass that causes drop in fibrinogen concentration increases the success rate of the graft and reduces the chances of myocardial infarction.…”