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[Effect of exercise tolerance test on hemostasis in patients with and without coronary heart disease]
M Lins1, T Arendt, A Deutschmann
1Klinik für Kardiologie, Christian-Albrechts-Universität zu Kiel. lins@cardio.uni-kiel.de
Insights
Standardized exercise tolerance tests do not increase the risk of thromboembolic events in coronary heart disease patients. Hemostatic variables showed no significant inter-group differences post-exercise.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Exercise Physiology
Context:
- Physical exercise can elevate coagulation, potentially increasing thromboembolic risk in coronary heart disease (CHD) patients.
- Bicycle exercise tolerance tests are common diagnostic tools for CHD.
- Understanding exercise's impact on hemostasis in CHD is crucial for patient safety.
Purpose:
- To investigate the influence of a standardized exercise tolerance test on hemostatic variables in patients with known coronary heart disease compared to a healthy cohort.
- To assess the risk of thromboembolic events associated with exercise testing in CHD patients.
Summary:
- A study compared hemostatic variables in 49 CHD patients and 51 healthy individuals before and after a standardized exercise tolerance test.
- No significant differences in hemostatic parameters were observed between the groups post-exercise.
- Within-group analysis revealed increases in factor VIII, von Willebrand factor, and plasminogen-alpha 2-antiplasmin in both groups.
Impact:
- Findings support the clinical presumption that standardized, aerobic exercise tolerance tests do not elevate thromboembolic risk in CHD patients.
- This research provides evidence for the safe use of exercise tolerance tests in diagnosing and managing coronary heart disease.
- The study contributes to the understanding of hemostatic balance during exercise in individuals with and without cardiovascular disease.
Background:
Physical exercise leads to an elevated coagulation activity with a possibly disturbed hemostatic balance. Therefore patients with coronary heart disease have a potentially increased risk of thromboembolic events after a bicycle exercise tolerance test, that is frequently performed for diagnostic reasons.
Patients And Methods:
Patients with angiographically known coronary heart disease (Group I: n = 49; age 59 years; male = 42, female = 7) were investigated in comparison to a healthy cohort (Group 2: n = 51; age 53 years; male = 44, female = 7) to study the influence of a standardized exercise tolerance test on hemostatic variables. Blood samples were taken before and after exercise.
Results:
No significant changes were found for any investigated parameter between both groups. However, 3 parameters did change significantly within the groups: factor VIII rose in Group 1 from 132 to 156% and in Group 2 from 106 to 136% and the von Willebrand factor rose in Group 1 from 230 to 249% and in Group 2 from 228 to 247%. An elevated fibrinolytic potential was found with an increase of plasminogen-alpha 2-antiplasmin in Group 1 from 251 to 401 micrograms/l and in Group 2 from 247 to 350 micrograms/l.
Conclusion:
The findings underline the clinical presumption that exercise tolerance test does not increase the risk for thromboembolic complications in patients with coronary heart disease in comparison to patients without coronary heart disease, as long as the exercise tolerance test is performed in a standardized way and under aerobe conditions.