Blood coagulation and fibrinolysis in healthy, untrained subjects: effects of different exercise intensities controlled by individual anaerobic threshold

The influence of different exercise intensities on haemostasis in healthy, untrained subjects has not been intensively studied. We investigated untrained subjects for alterations in coagulation and fibrinolysis induced by two exercise intensities, precisely controlled by individual anaerobic threshold (IAT). Twenty-five healthy, untrained non-smokers (age 25?±?3?years; relative VO₂ peak 43.1?±?5.2?ml/kg/min) underwent exercise tests at 80% (moderate) and 100% (strenuous) of IAT for 60?min. Blood samples were taken after 30?min rest and immediately after exercise. The present results reveal that an exercise intensity at 100% IAT induces a more pronounced coagulation activity than exercises at 80% IAT. 100% IAT led to a significant higher increase in FVIII (80% IAT 85?±?33 to 114?±?30% vs. 100% IAT 81?±?20 to 132?±?29%) and TAT (80% IAT 2.5?±?1.4 to 2.9?±?1.0???g/l vs. 100% IAT 2.6?±?1.0 to 5.4?±?4.2???g/l). Furthermore, both exercises affected fibrinolysis, but it was significantly higher at 100% IAT (tPA activity; 80% IAT 0.44?±?0.17 to 4.65?±?2.67?U/ml vs. 100% IAT 0.43?±?0.19 to 6.47?±?3.97?U/ml). The data show that fibrinolytic activity is significantly elevated already after moderate exercise (80% IAT). After strenuous exercise (100% IAT), coagulation is more sharply enhanced together with a higher increase of fibrinolysis in comparison with 80% IAT. However, haemostasis seems to be in balance after moderate as well as after strenuous exercise intensity in healthy, untrained participants. Based on these data, exercise-induced changes of both haemostatic systems should also be tested in patients with cardiovascular diseases in order to be in a position to give recommendations for endurance training modalities in rehabilitation training.     

Acute changes of coagulation and fibrinolysis parameters after experimental thromboembolic stroke and thrombolytic therapy

Thrombolysis is the only effective pharmaceutical therapy in acute ischemic stroke in humans but has a high risk of intracerebral hemorrhage. We aimed to establish an animal model to study changes of coagulation and fibrinolytic parameters during thromboembolic ischemic stroke and thrombolysis with recombinant tissue plasminogen activator (rt-PA). We used a thromboembolic stroke model in the rat. Animals were treated with rt-PA thrombolysis (n = 10) and compared with untreated (n = 10), sham operated (n = 10) and control animals (n = 20). Coagulation parameters (APTT, PT, TT, fibrinogen, AT III, TAT) and fibrinolytic parameters (t-PA antigen concentration, t-PA activity, PAI-1 concentration, PAI activity, plasminogen, antiplasmin) were measured at two time points (2.5 and 5 h after stroke induction) with a battery of commercially available test kits. We observed an (1) initiation of coagulation and inhibition of fibrinolysis by the operation procedure itself, (2) simultaneous activation of fibrinolysis and its inhibitors after stroke induction and (3) potent initiation of fibrinolysis and consumption of fibrinolysis inhibitors after rt-PA therapy of stroke. We established a model system to monitor coagulation and fibrinolysis during thrombolytic therapy of stroke in the rat. This model may be used to study the influence of these parameters on hemorrhagic stroke transformation and outcome in experimental stroke in future.