Physical Exertion Induces Thrombin Formation and Fibrin Degradation in Patients With Peripheral Atherosclerosis

Mustonen, Pirjo; Lepäntalo, Mauri; Lassila, Riitta

doi:10.1161/01.atv.18.2.244

Cited by 71 publications

(64 citation statements)

References 49 publications

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“…25 However, in a separate study, submaximal exercise in PAD patients with intermittent claudication was associated with an acute increase in thrombin formation. 26 Thus, associations between exercise and pro-thrombotic markers in patients with PAD are unclear.…”

Section: à21mentioning

confidence: 99%

Inflammatory markers, D-dimer, pro-thrombotic factors, and physical activity levels in patients with peripheral arterial disease

et al. 2004

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Men and women with lower extremity peripheral arterial disease (PAD) have reduced physical activity levels compared with persons without PAD. We describe associations between physical activity levels with D-dimer, pro-coagulant factors, and inflammatory markers in patients with PAD. Participants were188 patients with PAD identified from non-invasive vascular laboratories. Physical activity was measured over 7 days with a vertical accelerometer. We measured the ankleÀbrachial index (ABI) and levels of D-dimer, C-reactive protein (CRP), fibrinogen, serum amyloid A (SAA), prothrombin 1.2, t-PA antigen, PAI-1, and the t-PA antigen=PAI-1 ratio. Adjusting for age, sex, race, body mass index, ABI, comorbidities, smoking, total cholesterol=HDL ratio and statin use (for CRP only), we found significant inverse linear associations between physical activity levels and log D-dimer (p ¼ 0.002), log CRP (p < 0.001), fibrinogen (p ¼ 0.014), and log SAA (p ¼ 0.012). There were no significant associations between physical activity levels and other blood factors. In an analysis adjusting for all blood factors simultaneously along with known and potential confounders, log D-dimer was the only blood factor associated significantly with physical activity levels (p ¼ 0.036). Based on these findings, future studies should assess whether interventions to increase physical activity in patients with PAD reduce levels of D-dimer and inflammatory markers.

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Section: à21mentioning

confidence: 99%

Inflammatory markers, D-dimer, pro-thrombotic factors, and physical activity levels in patients with peripheral arterial disease

et al. 2004

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“…12 In most studies, baseline D-dimer levels are reported to be higher in claudicants compared to healthy controls. 2,16,19,20 D-dimer levels significantly increase after exercise compared to the respective levels of healthy controls, 2,16,19,20 and it appears to persist up to 1 h postexercise. 2 This increase is not significant when compared to the baseline values.…”

Section: Discussionmentioning

confidence: 86%

“…It is not clear if tPA or PAI-1 activity overwhelms the other, but to a degree a balance between the two antagonizing effects is reached. 16 Ratios between the tPA and PAI-1 activity and antigen levels would be useful to explore the state of balance, but unfortunately these are not used but in one of the already mentioned studies. 16 If we consider the few available data on post-exertion antigen valid, post-exertion tPA Ag concentration appears to decrease and PAI-1 Ag concentration appears to remain stable, 12,15 meaning a degree of clotting degradation.…”

Section: Discussionmentioning

confidence: 99%

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The effect of exercise on coagulation and fibrinolysis factors in patients with peripheral arterial disease

Patelis

Karaolanis

Kouvelos

et al. 2016

Exp Biol Med (Maywood)

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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.

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“…Vinogradsky et al (39) found abundant expression of PAT-1 in the atherosclerotic vascular wall. Further, attenuated fibrinolytic activity characterized as elevated circulating levels of PAI-1 has been frequently detected in patients with coronary artery disease (40) and peripheral vascular disease (41). In addition, increased plasma fibrinolytic activity and plasma clotlysis have been demonstrated in homozygous PAI-1-deficient mice (42).…”

Section: Fibrinolysismentioning

confidence: 99%

Direct Effects of Statins on Cells Primarily Involved in Atherosclerosis.

Chen

Ikeda²,

Shimpo³

et al. 2000

Hypertens Res

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Physical Exertion Induces Thrombin Formation and Fibrin Degradation in Patients With Peripheral Atherosclerosis

Cited by 71 publications

References 49 publications

Inflammatory markers, D-dimer, pro-thrombotic factors, and physical activity levels in patients with peripheral arterial disease

Inflammatory markers, D-dimer, pro-thrombotic factors, and physical activity levels in patients with peripheral arterial disease

The effect of exercise on coagulation and fibrinolysis factors in patients with peripheral arterial disease

Direct Effects of Statins on Cells Primarily Involved in Atherosclerosis.

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