Physical Exertion Induces Thrombin Formation and Fibrin Degradation in Patients With Peripheral Atherosclerosis

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Abstract
—Sudden extreme physical stress is associated with an increased risk of myocardial infarction mainly in people with preexisting atherosclerosis. In this study we compared the effect of submaximal exercise on coagulation and fibrinolysis in patients with peripheral arterial occlusive disease (PAOD) with that in healthy control subjects. Fifteen PAOD patients with intermittent claudication and 15 healthy control subjects, matched for age, sex, medication use, smoking habit, and conditioning, were studied. Thrombin–antithrombin III complex (TAT), d-dimer, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI)-1 antigens (Ag), t-PA activity, and plasmin-α2–antiplasmin complex (PAP), as well as plasma catecholamines, were measured before and after a treadmill exercise test. At rest, fibrinogen (3.3±0.5 versus 2.9±0.5 g/L [mean±SD]; P<.05), d-dimer (392±128 versus 271±113 ng/mL; P<.05), t-PA Ag (9.1±5.1 versus 5.5±1.2 ng/mL; P<.02), and PAI-1 Ag (14.9±7.1 versus 7.6±3.8 ng/mL; P<....