Exercise-induced stress significantly increased the incidence of irreversible platelet aggregation in patients with coronary artery disease (p<0.05 for 1 muM ADP and 10 muM epinephrine; p=0.02 for 1 muM epinephrine).
Case-Control (n=38)
Does exercise-induced stress increase platelet aggregation in patients with angina compared to normal controls?
Exercise significantly increases the tendency of platelets to aggregate in patients with coronary artery disease, suggesting a potential mechanism for stress-induced myocardial infarction.
p-value: p=<0.05
In order to determine if the stress of a standard exercise test will affect the propensity for platelets to aggregate, platelet aggregometer studies were performed before and after a double two-step Master's test in 19 patients with angina and in 19 normal controls. The response of platelet-rich plasma to 0.1, 1 and 10 muM of ADP and 1 and 10 muM of epinephrine were tested in a Chrono-Log aggregometer. Prior to exercise there was no significant difference between the number of patients and controls responding with irreversible aggregation to any of the five tests. Immediately following exercise, no significant differences in the number of irreversible aggregation responses were seen in the control group. In the group with coronary artery disease, the incidence of irreversible responses was significantly higher after exercise on test with 1 muM ADP (p less than 0.05), 1 muM epinephrine (p=0.02), and 10 muM epinephrine (p less than 0.05). It is concluded that exercise increases significantly the tendency of platelets to aggregate among patients with coronary artery disease. It is possible that this effect may play a role in myocardial infarction induced during stress.
Levites et al. (2008) conducted a case-control in Angina / Coronary artery disease (n=38). Exercise-induced stress (double two-step Master's test) vs. Normal controls / Baseline (prior to exercise) was evaluated on Incidence of irreversible platelet aggregation responses to ADP and epinephrine (p=<0.05). Exercise-induced stress significantly increased the incidence of irreversible platelet aggregation in patients with coronary artery disease (p<0.05 for 1 muM ADP and 10 muM epinephrine; p=0.02 for 1 muM epinephrine).