Haemostasis and fibrinolysis after regular high-intensity interval training in patients with coronary artery disease: a randomised controlled trial

Jacobina Kristiansen; Erik Lerkevang Grove; Tórur Sjúrðarson; Jan Rasmussen; Magni Mohr; Steen Dalby Kristensen; Anne-Mette Hvas

doi:10.1136/openhrt-2022-002127

Haemostasis and fibrinolysis after regular high-intensity interval training in patients with coronary artery disease: a randomised controlled trial

Open Heart. 2022 Nov;9(2):e002127. doi: 10.1136/openhrt-2022-002127.

Authors

Jacobina Kristiansen^{1

2

3}, Erik Lerkevang Grove^{4

5}, Tórur Sjúrðarson^{6

7}, Jan Rasmussen¹, Magni Mohr^{6

8}, Steen Dalby Kristensen^{3

5}, Anne-Mette Hvas³

Affiliations

¹ Department of Medicine, National Hospital of the Faroe Islands, Torshavn, Faroe Islands.
² Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
³ Faculty of Health, Aarhus University, Aarhus, Denmark.
⁴ Faculty of Health, Aarhus University, Aarhus, Denmark erikgrove@dadlnet.dk.
⁵ Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
⁶ Faculty of Health, University of the Faroe Islands, Torshavn, Faroe Islands.
⁷ Department of Nutrition, Exercise and Sports, University of Copenhagen, Kobenhavn, Denmark.
⁸ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.

Abstract

IntroductionPatients with coronary artery disease (CAD) have prothrombotic changes compared with healthy individuals. Regular exercise reduces cardiovascular mortality in patients with stable CAD. However, the underlying mechanism for the beneficial effect is unknown. We investigated whether regular exercise would inhibit platelet aggregation and thrombin generation and increase fibrinolysis in patients with CAD.

Materials and methods: Patients with CAD were randomised 1:1 to a supervised high-intensity exercise training programme or standard care for 12 weeks. Blood samples were obtained at baseline and after 6 and 12 weeks. Platelet aggregation was evaluated with the Multiplate Analyser, thrombin generation using the calibrated automated thrombogram and fibrinolysis employing a clot lysis assay.

Results: A total of 169 stable patients with CAD were randomised, and 142 patients (67±9 years, 83% males) completed the study; 64 in the exercise group and 78 in the standard care group. All but one patients received single antiplatelet therapy. From baseline to 12 weeks postintervention (Δ), no significant between-group differences were found in adenosine diphosphate-induced platelet aggregation (Δ-15 aggregation units (AU), AU×min, 95% CI -70 to 40 in the exercise group and Δ-26 AU×min, 95% CI -77 to 26 in the standard care group, p=0.44); endogenous thrombin potential (medians: Δ-5%, 95% CI -12 to 3 in the exercise group and Δ-6%, 95% CI -13 to 1 in the standard care group, p=0.26); nor in 50% clot lysis time (medians: Δ-9%, 95% CI -23 to 7 in the exercise group and Δ-17%, 95% CI -29 to -3 in the standard care group, p=0.60).

Conclusions: Twelve weeks of high-intensity whole-body endurance exercise did not affect platelet aggregation, thrombin generation or fibrinolysis in patients with stable CAD.

Trial registration number: NCT04268992.

Keywords: High-intensity interval training; blood coagulation; cardiovascular disease; fibrinolysis; platelet aggregation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Coronary Artery Disease* / diagnosis
Coronary Artery Disease* / therapy
Female
Fibrin Clot Lysis Time
Fibrinolysis
Hemostasis
High-Intensity Interval Training*
Humans
Male
Thrombin

Substances

Thrombin

Associated data

ClinicalTrials.gov/NCT04268992