Influence of cardiopulmonary exercise test on platelet function in patients with coronary artery diseases on antiplatelet therapy

• Published in: BMC cardiovascular disorders Vol. 22; no. 1; p. 87
• Main Authors: Yin, Chun, Wang, Yanhui, Mo, Chunhua, Yue, Zong, Sun, Yihong, Hu, Dayi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.03.2022; BioMed Central; BMC
• Subjects: Aggregation; Aspirin - adverse effects; Blood platelets; Cardiac rehabilitation; Care and treatment; Coronary Artery Disease - diagnosis; Coronary Artery Disease - drug therapy; Coronary artery diseases; Coronary heart disease; Diagnosis; Drug Therapy, Combination; Exercise Test; Exercise tests; Female; Humans; Male; Methods; Middle Aged; Platelet Aggregation; Platelet Aggregation Inhibitors - adverse effects; Platelet function; Platelet Function Tests; Risk factors; China; Coronary artery diseases; Exercise test; Cardiac rehabilitation; Platelet function
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-022-02486-z

Cardiac rehabilitation reduces mortality and morbidity rate of patients with coronary artery diseases (CAD); however, acute exercise stimulation may also increase the thrombotic risk through platelet activation. Studies on the effects of cardiac rehabilitation on platelet function have been sparse. A total of 28 patients (24 men and 4 women; average age = 54.6 ± 8 years old) with stable CAD were enrolled in this study and divided into Aspirin-treated (n = 11; Aspirin group) and dual-antiplatelet-treated group (DAPT group; n = 17). Symptom-limited cardiopulmonary exercise test (CPET) with a cycle ergometer was performed on all the patients. Before and after CPET, platelet function was evaluated using light transmission aggregometry and whole blood flow cytometry. All patients completed the CPET without provoked cardiac events, and the mean value of peak oxygen uptake (Peak Vo ) was 19.3 ± 3 ml/(kg min). Prior to CPET, platelet aggregation was significantly suppressed in DAPT group compared to Aspirin group (43.0 ± 21.5 vs. 72.9 ± 7.5, p < 0.001). CPET promoted platelet aggregation in Aspirin group (72.9 ± 7.5 vs. 80.9 ± 7.6, p = 0.005) and DAPT group (43.0 ± 21.5 vs. 50.1 ± 20.9, p = 0.010), and platelet count was increased in Aspirin (210.9 ± 54.6 vs. 227.5 ± 58.1, p = 0.001) and DAPT group (217.5 ± 63.8 vs. 229.7 ± 63.7, p = 0.001). However, the expression levels of CD62p and PAC-1 were not affected by CPET in both groups. Symptom-limited CPET enhanced platelet aggregation in patients with CAD despite treatment with antiplatelet, mainly via platelet count augmentation, but not through single platelet activation. Effects of high intensity interval training versus moderate intensity continue training in cardiac rehabilitation on platelet function of patients with coronary heart diseases: a exploratory randomized controlled trial. ChiCTR-INR-17010717. Registered 23 February 2017, https://www.chictr.org.cn/edit.aspx?pid=18206&htm=4 .