Coagulation activity and thrombotic risk following high-volume endurance exercise in recreationally active cyclists.

Abstract

Despite the prognostic effect of physical activity, acute bouts of high-volume endurance exercise can induce cardiac stress and post-exercise hypercoagulation associated with increased thrombotic risk. The aim of this study was to explore the effect of high-volume endurance exercise on coagulation and thrombotic activity in recreational cyclists. Thirty-four recreational cyclists completed 4.8 ± 0.3 hours cycling at 45 ± 5% of maximal power output on a bicycle ergometer. Intravenous blood samples were collected pre-exercise, immediately post-exercise, 24 and 48 hours post-exercise and analysed for brain natriuretic peptide (BNP), cardiac troponin (cTn), C-reactive protein (CRP), D-dimer, thrombin-antithrombin (TAT) complex, tissue factor (TF), tissue factor pathway inhibitor (TFPI) and TF to TFPI ratio (TF:TFPI). An increase in cTn was observed post-exercise (p < 0.001). CRP concentrations were increased at 24 and 48 hours post-exercise compared to pre-exercise concentrations (p ≤ 0.001). TF was elevated at 24 hours post-exercise (p < 0.031) and TFPI was higher immediately post-exercise (p < 0.044) compared to all other time points. TF:TFPI was increased at 24 and 48 hours post-exercise compared to pre-exercise (p < 0.025). TAT complex was reduced at 48 hours post-exercise compared to pre-exercise (p = 0.015), D-dimer was higher immediately post-exercise compared to all other time points (p ≤ 0.013). No significant differences were observed in BNP (p > 0.05). High-volume endurance cycling induced markers of cardiac stress among recreational cyclists. However, plasma coagulation and fibrinolytic activity suggests no increase in thrombotic risk after high-volume endurance exercise.