[Effect of physical exercise training on graft patency after aortocoronary bypass grafting]

This study evaluated the effect of physical exercise training on graft patency after aortocoronary bypass grafting (ACBG). Patients who underwent ACBG were randomized into the training (17 patients, 43 grafts) and nontraining groups (18 patients, 45 grafts). Tissue plasminogen activator (TPA) antigen, TPA activity, plasminogen activator inhibitor-1 (PAI-1) antigen and PAI-1 activity as fibrinolysis variables, and an angiographic study were performed 2 and 26 weeks after ACBG. Plasma TPA activity increased significantly in the training group, but not in the nontraining group after 24 weeks of training. Plasma PAI-1 antigen and activity decreased significantly in the training group, while PAI-1 levels remained unchanged in the nontraining group. Grafts were patent in 93% (40 of 43) of the training group and 76% (34 of 45) of the nontraining group (p < 0.05). A high plasma concentration of PAI-1 may interfere with the natural thrombolytic process. Exercise training can decrease PAI-1 levels and increase TPA activity after ACBG. Improved fibrinolysis obtained by exercise training may have beneficial effects on graft patency.