Aim: To study the effect of exercise on markers of endothelial impairment, platelet activation, thrombin formation, fibrinolysis in patients who survived myocardial infarction (MI) at young age.
Material and methods: The levels of fibrinogen (F), Willebrand factor (WF), beta-thromboglobulin (BTG), fragment 1+2 of prothrombin activation (F 1+2), antigen of tissue plasminogen activator (TPA), D-dimer at rest as well as betaTG, F 1+2, WF, TPA antigen and its activity in treadmill test (TT) were compared in 25 patients younger than 35 years who survived Q-myocardial infarction (Q-MI) > 6 months before (group 1), 10 of whom had unaffected or little affected coronary arteries as shown by coronaroangiography (subgroup 1H) while 15 had stenosing coronary atherosclerosis (subgroup 1A); in 20 patients who had Q-MI at the age of 40-55 years (group 2); in 10 healthy patients under 35 years of age (group 3).
Results: Initial concentrations of F, F 1+2 and TPA antigen were significantly higher than in healthy subjects. F and TPA antigen were higher in subgroup 1A than in subgroup 1H. D-dimer was higher in group 2 vs 1. TT raised concentration of BTG in all the groups, induced a stable trend of F 1+2 rise in patients of subgroup 1H (p = 0.059), raised WF only in group 3, TPA antigen at peak stress in all the patients being in group 1 higher than in healthy controls and in subgroup 1A than in subgroup 1H. TPA antigen was more active at the peak stress in group 1 than in group 2 but the differences became insignificant in analyzing only patients who reached submaximal load by heart rate.
Conclusion: Stenosing coronary atherosclerosis in patients after MI at young age is associated with high F and TPA levels. Elevated F 1+2 was registered at exercise test in young patients free of coronary obstruction. TPA levels were raised higher by exercise in patients with stenosing atherosclerosis of the coronary arteries. TPA activity induced by exercise depended more on exercise intensity than on the age of the patients.