Effect of marathon running on inflammatory and hemostatic markers

Although increasing levels of regular physical activity are incrementally c ardioprotective,(1,2) prolonged strenuous exercise such as marathon running may trigger acute myocardial infarction(3) and sudden cardiac death.(4,5) The mechanism of such events is not well understood but may be due to hemod ynamic, vasoconstrictive, and prothrombotic effects with disruption of unst able coronary plaques leading to acute coronary thrombosis.(6,7) Although s everal studies have demonstrated exercise-induced activation of fibrinolysi s and coagulation,(8) the effect of marathon running on hemostatic balance has not been well studied. We therefore measured changes in C-reactive prot ein (CRP), von Willebrand factor (vWF), D-dimer, fibrinogen, fibrinolytic a ctivity, white blood cell (WBC) counts, and platelet activation in middle-a ged runners before and after the Boston Marathon. An imbalance in prothromb otic and fibrinolytic factors after strenuous physical exertion may transie ntly increase the risk for intravascular-including coronary-thrombosis and trigger acute ischemic events.