A preliminary study on the effects of exercising to maximum walking distance on platelet and endothelial function in patients with intermittent claudication

P. Collins, Isobel Ford, D. R. Ball, Ewan MacAulay, Michael Greaves, Julie Brittenden

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background. Platelet and endothelial activation has been shown to be increased in patients with intermittent claudication (IC). Recent studies have suggested that exercise may induce further platelet activation. The anus of this study were to investigate the effect of exercising to maximum walking distance on platelet and endothelial function in patients with intermittent claudication who were receiving statin and aspirin therapy compared with age matched healthy controls.

Methods. Platelet aggregation through COX-mediated and thrombin receptor activator peptide (TRAP)-stimulated GPIIb/IIIa pathways was measured by the Ultegra point of care system in 20 patients with IC on aspirin and 20 healthy volunteers before, immediately and 1 h after exercising to treadmill maximal walking distance (MWD). Soluble P-selectin, nu WF and sICAM were measured using an enzyme linked immuno-sorbent assay technique.

Results. Baseline platelet aggregation was significantly reduced in patients with IC compared to volunteers (p < 0.05). In patients, exercising to MWD significantly reduced platelet aggregation (COX, median -5% [range -24 to 13%]; p= 0.02; GPIIIa/IIb, median -13% [range - 72 to 33%]; p = 0.02) immediately post-exercise which returned to baseline values at 1 h. There was no change in the healthy volunteers following the same median duration of exercise. Baseline sP-selectin levels were higher in the patients with IC compared to the healthy volunteers [Median values (interquartile range), 42.72 (33.28-54.24) versus 29.16 (24.40-34.10), p=0.0003] but there were no differences in nu WF levels. Both sP-selectin and nu WF levels increased significantly in the control and patient group following exercise (p < 0.005). sICAM were higher at baseline in the patients with IC but were unchanged following exercise [Median values (interquartile range),560.9 (405.5-739.4) versus 467.0 (325.7-643.4), p < 0.05].

Conclusion. This study is the first to show that platelet aggregation is reduced immediately following treadmill exercise to maximum walking distance in patients with IC despite a rise in sP-selectin and vWF, suggesting endothelial activation. The inhibition of platelet aggregation after exercise in subjects on antiplatelet and statin therapy suggests that exercise is unlikely to exacerbate platelet thrombus formation in patients with IC.

Original languageEnglish
Pages (from-to)266-273
Number of pages7
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume31
Issue number3
DOIs
Publication statusPublished - Mar 2006

Keywords

  • platelet aggregation
  • soluble P-selectin
  • sICAM
  • von Willebrand factor
  • exercise
  • intermittent claudication
  • peripheral arterial-disease
  • intercellular-adhesion molecule-1
  • Von-Willebrand-Factor
  • P-selectin
  • activated platelets
  • treadmill exercise
  • vascular-disease
  • nitric-oxide
  • aggregation
  • coagulation

Cite this

@article{66d02476498c469392d24dd41f86bee8,
title = "A preliminary study on the effects of exercising to maximum walking distance on platelet and endothelial function in patients with intermittent claudication",
abstract = "Background. Platelet and endothelial activation has been shown to be increased in patients with intermittent claudication (IC). Recent studies have suggested that exercise may induce further platelet activation. The anus of this study were to investigate the effect of exercising to maximum walking distance on platelet and endothelial function in patients with intermittent claudication who were receiving statin and aspirin therapy compared with age matched healthy controls.Methods. Platelet aggregation through COX-mediated and thrombin receptor activator peptide (TRAP)-stimulated GPIIb/IIIa pathways was measured by the Ultegra point of care system in 20 patients with IC on aspirin and 20 healthy volunteers before, immediately and 1 h after exercising to treadmill maximal walking distance (MWD). Soluble P-selectin, nu WF and sICAM were measured using an enzyme linked immuno-sorbent assay technique.Results. Baseline platelet aggregation was significantly reduced in patients with IC compared to volunteers (p < 0.05). In patients, exercising to MWD significantly reduced platelet aggregation (COX, median -5{\%} [range -24 to 13{\%}]; p= 0.02; GPIIIa/IIb, median -13{\%} [range - 72 to 33{\%}]; p = 0.02) immediately post-exercise which returned to baseline values at 1 h. There was no change in the healthy volunteers following the same median duration of exercise. Baseline sP-selectin levels were higher in the patients with IC compared to the healthy volunteers [Median values (interquartile range), 42.72 (33.28-54.24) versus 29.16 (24.40-34.10), p=0.0003] but there were no differences in nu WF levels. Both sP-selectin and nu WF levels increased significantly in the control and patient group following exercise (p < 0.005). sICAM were higher at baseline in the patients with IC but were unchanged following exercise [Median values (interquartile range),560.9 (405.5-739.4) versus 467.0 (325.7-643.4), p < 0.05].Conclusion. This study is the first to show that platelet aggregation is reduced immediately following treadmill exercise to maximum walking distance in patients with IC despite a rise in sP-selectin and vWF, suggesting endothelial activation. The inhibition of platelet aggregation after exercise in subjects on antiplatelet and statin therapy suggests that exercise is unlikely to exacerbate platelet thrombus formation in patients with IC.",
keywords = "platelet aggregation, soluble P-selectin, sICAM, von Willebrand factor, exercise, intermittent claudication, peripheral arterial-disease, intercellular-adhesion molecule-1, Von-Willebrand-Factor, P-selectin, activated platelets, treadmill exercise, vascular-disease, nitric-oxide, aggregation, coagulation",
author = "P. Collins and Isobel Ford and Ball, {D. R.} and Ewan MacAulay and Michael Greaves and Julie Brittenden",
year = "2006",
month = "3",
doi = "10.1016/j.ejvs.2005.10.011",
language = "English",
volume = "31",
pages = "266--273",
journal = "European Journal of Vascular and Endovascular Surgery",
issn = "1078-5884",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - A preliminary study on the effects of exercising to maximum walking distance on platelet and endothelial function in patients with intermittent claudication

AU - Collins, P.

AU - Ford, Isobel

AU - Ball, D. R.

AU - MacAulay, Ewan

AU - Greaves, Michael

AU - Brittenden, Julie

PY - 2006/3

Y1 - 2006/3

N2 - Background. Platelet and endothelial activation has been shown to be increased in patients with intermittent claudication (IC). Recent studies have suggested that exercise may induce further platelet activation. The anus of this study were to investigate the effect of exercising to maximum walking distance on platelet and endothelial function in patients with intermittent claudication who were receiving statin and aspirin therapy compared with age matched healthy controls.Methods. Platelet aggregation through COX-mediated and thrombin receptor activator peptide (TRAP)-stimulated GPIIb/IIIa pathways was measured by the Ultegra point of care system in 20 patients with IC on aspirin and 20 healthy volunteers before, immediately and 1 h after exercising to treadmill maximal walking distance (MWD). Soluble P-selectin, nu WF and sICAM were measured using an enzyme linked immuno-sorbent assay technique.Results. Baseline platelet aggregation was significantly reduced in patients with IC compared to volunteers (p < 0.05). In patients, exercising to MWD significantly reduced platelet aggregation (COX, median -5% [range -24 to 13%]; p= 0.02; GPIIIa/IIb, median -13% [range - 72 to 33%]; p = 0.02) immediately post-exercise which returned to baseline values at 1 h. There was no change in the healthy volunteers following the same median duration of exercise. Baseline sP-selectin levels were higher in the patients with IC compared to the healthy volunteers [Median values (interquartile range), 42.72 (33.28-54.24) versus 29.16 (24.40-34.10), p=0.0003] but there were no differences in nu WF levels. Both sP-selectin and nu WF levels increased significantly in the control and patient group following exercise (p < 0.005). sICAM were higher at baseline in the patients with IC but were unchanged following exercise [Median values (interquartile range),560.9 (405.5-739.4) versus 467.0 (325.7-643.4), p < 0.05].Conclusion. This study is the first to show that platelet aggregation is reduced immediately following treadmill exercise to maximum walking distance in patients with IC despite a rise in sP-selectin and vWF, suggesting endothelial activation. The inhibition of platelet aggregation after exercise in subjects on antiplatelet and statin therapy suggests that exercise is unlikely to exacerbate platelet thrombus formation in patients with IC.

AB - Background. Platelet and endothelial activation has been shown to be increased in patients with intermittent claudication (IC). Recent studies have suggested that exercise may induce further platelet activation. The anus of this study were to investigate the effect of exercising to maximum walking distance on platelet and endothelial function in patients with intermittent claudication who were receiving statin and aspirin therapy compared with age matched healthy controls.Methods. Platelet aggregation through COX-mediated and thrombin receptor activator peptide (TRAP)-stimulated GPIIb/IIIa pathways was measured by the Ultegra point of care system in 20 patients with IC on aspirin and 20 healthy volunteers before, immediately and 1 h after exercising to treadmill maximal walking distance (MWD). Soluble P-selectin, nu WF and sICAM were measured using an enzyme linked immuno-sorbent assay technique.Results. Baseline platelet aggregation was significantly reduced in patients with IC compared to volunteers (p < 0.05). In patients, exercising to MWD significantly reduced platelet aggregation (COX, median -5% [range -24 to 13%]; p= 0.02; GPIIIa/IIb, median -13% [range - 72 to 33%]; p = 0.02) immediately post-exercise which returned to baseline values at 1 h. There was no change in the healthy volunteers following the same median duration of exercise. Baseline sP-selectin levels were higher in the patients with IC compared to the healthy volunteers [Median values (interquartile range), 42.72 (33.28-54.24) versus 29.16 (24.40-34.10), p=0.0003] but there were no differences in nu WF levels. Both sP-selectin and nu WF levels increased significantly in the control and patient group following exercise (p < 0.005). sICAM were higher at baseline in the patients with IC but were unchanged following exercise [Median values (interquartile range),560.9 (405.5-739.4) versus 467.0 (325.7-643.4), p < 0.05].Conclusion. This study is the first to show that platelet aggregation is reduced immediately following treadmill exercise to maximum walking distance in patients with IC despite a rise in sP-selectin and vWF, suggesting endothelial activation. The inhibition of platelet aggregation after exercise in subjects on antiplatelet and statin therapy suggests that exercise is unlikely to exacerbate platelet thrombus formation in patients with IC.

KW - platelet aggregation

KW - soluble P-selectin

KW - sICAM

KW - von Willebrand factor

KW - exercise

KW - intermittent claudication

KW - peripheral arterial-disease

KW - intercellular-adhesion molecule-1

KW - Von-Willebrand-Factor

KW - P-selectin

KW - activated platelets

KW - treadmill exercise

KW - vascular-disease

KW - nitric-oxide

KW - aggregation

KW - coagulation

U2 - 10.1016/j.ejvs.2005.10.011

DO - 10.1016/j.ejvs.2005.10.011

M3 - Article

VL - 31

SP - 266

EP - 273

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 3

ER -