The influence of the exercise tolerance test on hemostasis in patients with and without coronary heart disease

Background: Physical exercise leads to an elevated coagulation activity wit h a possibly disturbed hemostatic balance. Therefore patients with coronary heart disease have a potentially increased risk of thromboembolic events a fter a bicycle-exercise tolerance test, that is frequently performed for di agnostic reasons. Patients and Methods: Patients with angiographically known corollary heart disease (Group 1: n = 49 age 59 years; male = 42, female = 7) were investig ated in comparison to a healthy cohort (Group 2: n = 51; age 53 years; male = 44, female = 7) to study the influence of a standardized exercise tolera nce test on hemostatic variables. Blood samples were taken before and after exercise. Results: No significant changes were found for any investigated parameter b etween both groups. However 3 parameters did change significantly within th e groups: factor VIII rose in Group 1 from 132 to 156% and in Group 2 from 106 to 136% and the von Willebrand factor rose in Group 1 from 230 to 249% and in Group 2 from 228 to 247%. An elevated fibrinolytic potential was fou nd with an increase of plasminogen-alpha(2)-antiplasmin in Group 1 from 251 to 401 mu g/l and in Group 2 from 247 to 350 mu g/l. Conclusion: The findings underline the clinical presumption that exercise t olerance test does not increase the risk for thromboembolic complications i n patients with coronary heart disease in comparison to patients without co ronary heart disease, as long as the exercise tolerance test is performed i n a standardized way and under aerobe conditions.