Leisure time emotional excitement increases endothelin-1 and interleukin-6 in cardiac patients

OBJECTIVES. Emotional excitement may trigger serious cardiovascular (CV) events. Our objective was to compare the changes in potential surrogate markers of CV events in patients with coronary artery disease (CAD) during emotional excitement and exercise. DESIGN. Fifty-three enthusiastic ice-hockey spectators with stable CAD attended the Finnish national ice-hockey play-off matches and a maximal bicycle exercise. Plasma catecholamines, endothelin-1, interleukin-6, and markers of platelet activation and blood coagulation were determined before and during the match and before and after the exercise. RESULTS. Plasma endothelin-1 (2.82 ± 0.21 vs. 2.94 ± 0.25 pg/mL, p < 0.0001), noradrenaline (4.38 ± 1.79 vs. 4.77 ± 1.75 nmol/L, p = 0.009) and interleukin-6 (2.04 ± 1.98 vs. 2.90 ± 2.41 pg/mL, p < 0.0001) increased during the match, but markers of platelet activation and coagulation remained unchanged. Endothelin-1 did not change during exercise (2.73 ± 0.17 vs. 2.72 ± 0.19 pg/mL, p = 0.593) but noradrenaline (2.70 ± 1.08 vs.10.6 ± 5.5 nmol/L), adrenaline (0.23 ± 0.13 vs. 0.52 ± 0.37 nmol/L), interleukin-6 (1.77 ± 1.59 vs. 2.43 ± 1.78 pg/mL) and markers of platelet activation and blood coagulation increased significantly (p < 0.0001 for all). CONCLUSIONS. The responses of surrogate markers of acute CV events to emotional excitement and physical exercise are partly different. Emotional excitement causes concomitant increases in markers reflecting vulnerability to atherosclerotic plaque complications while physical exercise causes more prominent changes in markers of coagulation.