Effects of exercise on markers of hemostatic activation inyoung survivors of myocardial infarction


Aim. To study the effect of exercise on markers of endothelial impairment, platelet activation,
thrombin formation, fibrinolysis in patients who survived myocardial infarction (MI) at young age.
Material and methods. The levels of fibrinogen (F), Willebrand factor (WF), beta-thromboglobulin
(BTG), fragment 1+2 of prothrombin activation (F 1+2), antigen of tissue plasminogen activator
(TPA), D-dimer at rest as well as BTG, F 1 = 2, WF, TPA antigen and its activity in treadmill test
(TT) were compared in 25 patients younger than 35 years who survived Q-myocardial infarction (Q-MI) > 6
months before (group 1), 10 of whom had unaffected or little affected coronary arteries as
shown by coronaroangiography (subgroup Ш) while 15 had stenosing coronary atherosclerosis (subgroup 1A);
in 20 patients who had Q-MI at the age of 40-55 years (group 2); in 10 healthy patients
under 35 years of age (group 3).
Results. Initial concentrations of F, F 1 + 2 and TPA antigen were significantly higher than in
healthy subjects. F and TPA antigen were higher in subgroup 1A than in subgroup 1H. D-dimer was
higher in group 2 vs 1. TT raised concentration of BTG in all the groups, induced a stable trend of F
1+2 rise in patients of subgroup IE (p = 0.059), raised WF only in group 3, TPA antigen at peak
stress in all the patients being in group 1 higher than in healthy controls and in subgroup 1A than in
subgroup 1H. TPA antigen was more active at the peak stress in group 1 than in group 2 but the differences
became insignificant in analyzing only patients who reached submaximal load by heart rate.
Conclusion. Stenosing coronary atherosclerosis in patients after MI at young age is associated with
high F and TPA levels. Elevated F 1+2 was registered at exercise test in young patients free of coronary
obstruction. TPA levels were raised higher by exercise in patients with stenosing atherosclerosis of
the coronary arteries. TPA activity induced by exercise depended more on exercise intensity than on
the age of the patients.


  1. Zimmerman F. Ft., Cameron A., Fisher L. D. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis. (Coronary Artery Surgery Registry). J. Am. Coll. Cardiol. 1995; 26(3): 654-661.
  2. Fournier J. A., Sanchez A., Quero J. Myocardial infarction in men aged 40 years or less: a prospective clinical-angiographic study. Clin.Cardiol. 1996; 19: 631-636.
  3. Зяблое Ю. И., Округин С. А., Орлова С. Л. Острые коронарные катастрофы у лиц до 40 лет: результаты 10-летнего наблюдения в Томске по программе ВОЗ "Регистр острого инфаркта миокарда". Кардиология 1999; 11: 47-50.
  4. Osula S., Bell G. M., Hornung R. S. Acute myocardial infarction in young adults: causes and management. Postgrad. Med. J. 2002; 78: 27-30.
  5. Fuster V., Badimon L., Badimon J. J., Chesebro J. H. The pathogenesis of coronary artery disease and the acute coronary syndromes. (First and second of two part). N. Eng. J. Med. 1992; 242-250; 310-318.
  6. Панченко Е. П., Добровольский А. Б. Тромбозы в кардиологии. Механизмы развития и возможности терапии. М.: 1999.
  7. Malnmberg К., Bavenholm P., Hamsten A. Clinical and biochemical factors assosiated with prognosis after myocardial infarction at a young age. J. Am.Coll. Cardiol. 1994; 24: 592- 599.
  8. Ciampricotti I., El Gamal M., Relik T. et al. Clinical characteristics and coronary angiographic findings of patients with unstable angina, acute myocardial infraction, and survivors of sudden ischemic death occurring during and after sport. Am. Heart. J. 1990; 120: 1267-1277.
  9. Mittleman M. A., Maclure M., Tofler G. H et al. Triggering of acute myocardial infarction by heavy physical exertion: protection against triggering by regular exercise. N. Engl. J. Med. 1993; 329: 1677-1683.
  10. Fournier J. A., Sanchez-Gonzalez A., Quero J. et al. Normal angiogram after myocardial infarction in young patients: a prospective clinical-angiographic and long-term follow-up study.Int. J. Cardiol. 1997; 60(3): 187-281.
  11. Малая Л. Т., Вол/сов В. И., Аляви А. Л. Инфаркт миокарда у лиц молодого возраста. Клин. мед. 1976; 4: 26-33.
  12. Meade Т. W., Ruddock V., Stirling Y. et al. Fibrinolytic activity, clotting factors and long-term incidence of ischemic heart disease in Northwick Park Heart Study. Lancet 1993; 342: 1076-1079.
  13. Ridker P. M., Vaughan D. E., Stampfer M. J. et al. Endogenous tissue type plasminogen activator and risk of myocardial infarction. Lancet 1993; 341: 1165-1168.
  14. Hamsten A., Wiman В., DeFaire U., Blomback M. Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N. Engl. J. Med. 1985; 313: 1557-1563.
  15. Martinez-Sales V,, Vila V., Reganon E. et al. Elevated thrombotic activity after myocardial infarction: A 2-year follow-up study. Haemostasis 1998; 28(6): 301-306.
  16. Reganon E., Vila V., Martinez-Sales V. et al. Inflammation, fibrinogen and thrombin generation in patients with previous myocardial infarction. Haematologica 2002; 87(7): 740-745.
  17. Keinast J., Thompson S. G., Raskino С. et al. Prothrombin activation fragment 1+2 and thrombin antithrombin 111 complexes in patients with angina pectoris: relation to presence and severity of coronary atherosclerosis. Thromb. Haemost. 1993; 70: 550-553.
  18. Herren Т., Sticker H., Haeberli A. et al. Fibrin formation and degradetion in patients with arteriosclerotic disease. Circulation 1994; 90: 2679-2686.
  19. Thompson S. G., Van De Loo J. С V. ECAT Angina Pectoris Study Group. ECAT Angina Pectoris Study: baseline associations of haemostatic factors with extent of coronary arteriosclerosis and other coronary risk factors in 3000 patients with angina pectoris undergoing coronary angiography. Eur. Heart. J. 1993; 14: 8-17.
  20. Abbate R., Prisco D., Rostangno C. et al. Age-related changes in the hemostatic system. Int. J. Clin. Lab. Res. 1993; 23: 1-3.
  21. Van den Burg P. J. M., Hospers J. E. H., van Vliet M. et al. Aging, physical conditioning, and exercise-induced changes in hemostatic factors and reaction products. J. Appl. Physiol. 2000; 88: 1558-1564.
  22. Smith D. Т., Hoetzer G. L., Greiner J. J. et al. Effects of ageing and regular aerobic exercise on endothelial fibrinolytic capacity in humans. J. Physiol. (Lond.) 2003; 546 (pt 1): 289-298.
  23. Lassila R., Peltonen S., Lepantalo M. et al. Severity of peripheral atherosclerosis is associated with fibrinogen and degradation of cross-linked fibrin. Arterioscler. Thromb.1993; 13: 1412-1417.
  24. Landolfl R., Scabbia E., Accorra F. et al. Beta-thromboglobulin in patients with acute and chronic coronary artery disease. Acta Cardiol. 1982; 37(5): 325-332.
  25. Wallen N. H., Held C., Rehnqvist N., Hjemdahl P. Effects of mental and physical stress on platelet function in patients with stable angina pectoris and healthy controls. Eur.Heart J. 1997; 18(5): 807-815.
  26. Lins M., Arendt I., Deutschmann A. et al. Effect of exercise tolerance test on hemostasis in patients with and without coronary heart disease. Med. Klin. 2000; 95(1): 14-19.
  27. Wang J.S., Jen С. G., Kung H.-C. et al. Different effects of strenuous and moderate exercise on platelet function in men. Circulation 1994; 90: 2877-2885.
  28. Schernthaner G., Muhlhauser I., Bohm H. et al. Exercise induces in vivo platelet activation in patients with coronary artery disease and in healthy individuals. Haemostasis 1983; 13(6): 351-357.
  29. Hurlen M., Seljeflot I., Arnesen H. Increased platelet aggregability during exercise in patients with previous myocardial infarction. Lack of inhibition by aspirin. Thromb. Res.2000; 99: 487-494.
  30. Douste-Blazy P., Sie P., Boneu B. et al. Exercise-induced platelet activation in myocardial infarction survivors with normal coronary arteriogram. Thromb. Haemost. 1984; 52(3): 297- 300.
  31. Strauss W. E., Cella G., Parisi A. F., Sasahara A. A. Serial studies of platelet factor 4 and beta-thromboglobulin during exercise in patients with coronary artery disease. Am. Heart. J. 1985; 110(2): 293-299.
  32. Wallen N. H., Goodall A. H., Li N., Hjemdahl P. Activation of haemostasis by exercise, mental stress and adrenaline: effects on platelet sensitivity to thrombin and thrombin generation. Clin. Sci. 1999; 97(1): 27-35.
  33. Weiss C., Seitel G., Bartsch P. Coagulation and fibrinolysis after moderate and very heavy exercise in healthy male subjects. Med. Sci. Sports Exerc. 1998; 30(2): 246-251.
  34. Rocker L., Meckel M., Westpfahl K. P., Gunga H. C. Influence of maximal ergometric exercise on endothelin concentrations in relation to molecular markers of the hemostatic system. Thromb. Haemost. 1996; 75(4): 612-616.
  35. Bounameaux H., Righetti A., de Moerloose P. et al. Effects of exercise test on plasma markers of an activation of coagulation and/or fibrinolysis in patients with symptomatic or silent myocardial ischemia. Thromb. Res. 1992; 65(1): 27-32.
  36. Weiss C., Velich Т., Niebauer J. et al. Activation of coagulation and fibrinolysis after rehabilitative exercise in patients with coronary artery disease. Am. J. Cardiol. 1998; 81(6): 672-677.
  37. Szymanski L. M., Pate R. R., Durstine J. L. Effects of maximal exercise and venous occlusion on fibrinolytic activity in physically active and inactive men. J. Appl. Physiol. 1994; 77: 2305-2310.
  38. Fernhall В., Szymanski L. M., Gorman P. A. et al. Fibrinolytic activity is similar in physically active men with and without a history of myocardial infarction. Arterioscler. Thromb. Vase. Biol. 1997; 17: 1106-1113.
  39. Rydzewski A., Sakata K., Kobayashi A. et al. Changes in plasminogen activator inhibitor 1 and tissue-type plasminogen activator during exercise in patients with coronary artery disease. Haemostasis 1990; 20(5): 305-312.
  40. Chandler W. L., Levy W. C., Stratton J. R. et al. The circulatory regulation of tPA and uPA secretion, clearence and inhibition during exercise and during the infusion of isoprerenol and phenylephrine. Circulation 1995; 92: 2984-2994.
  41. Chandler W. L., Trimble S. L., Loo S. C., Mornin D. Effect of PAI-1 levels on the molar concentrations of active tissue plasminogen activator (t-PA) and t-PA/PAI-1 complex in plasma. Blood 1990; 76: 930-937.
  42. Drygas W. K., Rocker L., Boldt F. et al. The hemostatic and fibrinolytic system in normal subjects and myocardial infarct patients. Effect of a standardized aerobic and anaerobic ergometric stress test. Dtsch. Med. Wschr. 1987; 112(25): 995-999.



Abstract - 85


Article Metrics

Metrics Loading ...


  • There are currently no refbacks.

Copyright (c) 2004 Vitsenya M.V., Noeva E.A., Titaeva E.V., Dobrovolsky A.B.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:


© 2018 "Consilium Medicum" Publishing house

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies