Influence of an ultramarathon race at moderate altitude on coagulation and fibrinolysis

Acute physical exercise induces a temporary increase in blood coagulability as well as in fibrinolysis. Only few data have been reported concerning the hemostatic system after long lasting strenuous exercise. In order to evaluate the consequences of prolonged strenuous endurance exercise on the hemostatic system, 11 athletes were examined before, immediately after as well as 24 h after the start of a 67 km mountain run. Immediately after the race we found significant increases in thrombin-antithrombin III complexes (TAT; 1.4-fold), in D-dimer (1.4-fold), in plasmin-alpha(2)-antiplasmin complexes (PAP; 3.9-fold), in tissue type plasminogen activator (t-PA; 3.7-fold) and in t-PA-plasminogen activator inhibitor-1 complexes (t-PA-PAI-1; 7.6-fold), Antithrombin III as well as PAI-1 remained unchanged. One day after the start of the race only PAP complexes were significantly elevated (1.7-fold). This study demonstrates that extreme long lasting endurance exercise activates both, the coagulatory as well as the fibrinolytic system. As compared with the activation of fibrinolysis the activation of the coagulation is small. Thus, we conclude that prolonged strenuous endurance exercise seems not to be associated with a high prothrombotic potential.