Platelet Activity, Coagulation, and Fibrinolysis During Exercise in Healthy Males

Abstract

Background-Relationships between exercise-induced activation of platelets, blood coagulation, and fibrinolysis, and the importance of thrombin for responses to exercise are not clear. Methods and Results-Effects of thrombin inhibition on hemostatic parameters were examined in a double-blind crossover study comparing the direct thrombin inhibitor argatroban (350 g/kg intravenous bolus followed by 25 g/kg per minute of infusion), the indirect thrombin inhibitor enoxaparin (0.75 mg/kg, intravenous bolus), or placebo (saline) in 21 healthy males. Measurements were made at rest, before and during/after thrombin inhibitor treatment, and immediately after exhaustive exercise. At rest argatroban abolished, and enoxaparin attenuated platelet activation by thrombin, but not by adenosine diphosphate. Argatroban and, even more so, enoxaparin decreased thrombin generation (prothrombin F1ϩ2) and the coagulation potential, and increased the fibrinolytic potential. Exercise increased circulating activated platelets (from 5.5Ϯ0.3 to 9.4Ϯ0.9ϫ10 9 /L; PϽ0.001), circulating platelet-platelet microaggregates, the platelet responsiveness to in vitro stimulation, leukocyte activation (leukocyte CD11b expression and plasma elastase), and platelet-leukocyte aggregation (PϽ0.01 for all). Exercise increased coagulation (F1ϩ2; PϽ0.01) and fibrinolysis, but did not alter the balance between them; fibrin gel permeability increased (PϽ0.01), probably because of release of endogenous tissue plasminogen activator from the vessel wall. Neither argatroban nor enoxaparin counteracted exercise-induced platelet or leukocyte activation. Both thrombin inhibitors augmented exercise effects on fibrinolysis. Conclusions-Strenuous exercise enhances platelet and leukocyte activation independently of thrombin. Exercise augments both coagulation and fibrinolysis, but the balance between them appears to be maintained. At therapeutic dosages argatroban counteracted thrombin-induced platelet activation most efficiently, whereas enoxaparin had somewhat stronger anticoagulant and profibrinolytic effects.

Effects of Exercise in Combination With Epoetin Alfa During High-Dose Chemotherapy and Autologous Peripheral Blood Stem Cell Transplantation for Multiple Myeloma

“…Exercise augments coagulation and fibrinolysis while maintaining the balance in the two processes (Li, He, Blomback, & Hjemdahl, 2007). Exercise has been shown to increase circulating activated platelets (Li et al) and the change is partially explained by an increase in platelet counts induced by exercise (Ahmadizad, El-Sayed, & Maclaren, 2006;Aldemir & Kilic, 2005).…”

Effects of Anaerobic Exercise on some Coagulation Factors in Non-Athletes Female Students of Islamic Azad University of Sanandaj

“…In another study, colon and colleagues (1997 ) reported increased catabolism of fibrinogen and plasminogen looking physically strenuous activity but did not observe significant changes in PT ( 14 ). Naylyn ( 2007) With Survey Platelet activity, coagulation and fibrinolysis during exercise in healthy men exercise increases the concentration of platelets and leukocytes were observed independent of coagulation and fibrinolysis by thrombin is increased but the balance between the sport seems to be maintained ( 26 ). Quinn (2009) stated fibrinolytic activity in postmenopausal women could be improved by 3 weeks of regular training programs under the maximum (21).. Madarameh et al (2010 ) concluded after exercise any of the variables prothrombin complex thrombin -antithrombin 3 and D.Dimer type did not change significantly ( 24 ).…”

Impact of Regular Exercise on Arterial Stiffness and Cerebral Blood Flow in Adults

“…Despite the beneficial effects of exercise (PiePoli et al, 2004;Bassuk and Manson, 2005;Roberts and Barnard, 2005), several studies have found that exercise may induce damaging effects such as acute coronary syndrome (Willich et al, 1993), increased platelet and leukocyte activations, elevated platelet-leukocyte aggregations, and facilitation of thrombogenesis (Li et al, 2007). Additionally, exercise may cause increased stress-induced shear force, and promote platelet and coagulation system activation, catecholamine release (Ikarugi et al, 1999).…”