Elsevier

Thrombosis Research

Volume 89, Issue 2, 15 January 1998, Pages 73-78
Thrombosis Research

REGULAR ARTICLE
Evaluation of Clotting and Fibrinolytic Activation after Protracted Physical Exercise

https://doi.org/10.1016/S0049-3848(97)00293-4Get rights and content

Abstract

The behavior of hemostatic system activation during protracted physical exercise is well known, but the duration of its modification is not yet defined. In order to evaluate the time of hemostatic system activation after prolonged strenuous endurance physical exercise (typical marathon race: 42.195 km, v=15.35 km/h; mean length of time run 2.45± 0.15 hours) 12 well-trained long-distance male runners (mean age: 35±7, range 25–47 years) were investigated. Blood samples were drawn in the morning on the day before the performance, immediately after the race, and 24 hours and 48 hours after the end of run. With respect of baseline, immediately after the race, a significant decrease of fibrinogen (−25%) and significant increases of prothrombin fragment 1+2 (+633%) and thrombin-antithrombin complex (+848%) were observed. A significant acceleration of euglobulin lysis time (−41%), and rises of plasma levels of tissue plasminogen activator antigen (+361%), plasminogen activator inhibitor type 1 antigen (+235%), d-dimer (+215%), and plasma fibrinogen degradation products (+1200%) were also found. Only a slight, yet not significant, decrease in plasminogen activator inhibitor type 1 activity was observed. One day after the end of marathon different parameters were still unchanged. Forty-eight hours after the competition all parameters investigated returned to baseline values. These results indicate a persistence of clotting as well as fibrinolysis activation up to 24 hours after the end of the race.

Section snippets

Study Design

Twelve healthy male runners aged 25 to 47 years (35±6.5 yrs) were included in the study, after having given their informed consent. The study was designed according to the principles of the Declaration of Helsinki. No participant had either used any drugs, or changed dietary habits for at least 8 days before the run and during the study period. All participants were well-trained long-distance runners involved in regular training for several years (training distance per week was about 100 km).

Statistical Analysis

Results are reported as median and range. Comparisons of the levels of different markers throughout the study were performed by non-parametric ANOVA (Kruskall-Wallis test) and Wilcoxon rank sum test (paired values). Any probability below 0.05 was considered to represent a significant difference.

Results

Table 1 shows the range and median values of different parameters observed before and after the competition. In comparison with baseline, a significant decrease of Fbg (−25%, p<0.001) and significant increases of F1+2 (+633%, p<0.001) and TAT (+848%, p<0.001) were observed in samples obtained immediately after the race.

The study of fibrinolysis showed a significant acceleration of ELT after the race (−41%, p< 0.001). Moreover, significant increases of plasma levels of t-PA ag (+361%, p<0.001),

Discussion

The results of this study indicate that the prolonged physical exercise of a marathon run leads to a marked activation of coagulation and fibrinolysis. As a whole, these modifications are similar to those already reported for strenuous exercise [1] with some peculiar aspects possibly related to the special kind of effort (strenuous but lasting some hours). Previous investigations on marathon or other activities which imply a prolonged strenuous exercise are scarce in the literature and

Conclusions

The results of the present study, together with those of the literature, indicate that even if short-term strenuous exercise can induce an activation of coagulation and fibrinolysis, there is not always fibrin generation in the bloodstream nor are there levels of free plasmin able to induce measurable amounts of fibrinogen and/or fibrin split products. This may occur depending on type, intensity, and duration of exercise, individual characteristics (age, fitness, training) and possibly

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