Haemostasis and fibrinolysis after regular high-intensity interval training in patients with coronary artery disease: a randomised controlled trial
Question
Whether regular supervised high-intensity exercise training reduces platelet aggregation and coagulation and increases fibrinolysis in patients with stable coronary artery disease compared with standard medical care.
Summary
This randomized controlled trial tested whether 12 weeks of supervised low-volume high-intensity whole-body endurance exercise changed haemostasis or fibrinolysis markers in stable coronary artery disease. One hundred sixty-nine patients were randomized and 142 completed the study. The exercise arm trained three times weekly on rowing ergometers, but platelet aggregation, thrombin generation, and clot lysis did not differ significantly from standard care after 12 weeks, despite prior reporting from the same trial that VO2peak improved by about 10% in the exercise group.
Methodology
- Stable adults with angiographically confirmed coronary artery disease, mostly older men, randomized to supervised high-intensity rowing exercise or standard medical care.
- 142 participants.
- Rowing ergometer.
- Intensity: High-intensity exercise training; exact target not specified in this article.
- 18 active minutes; total session duration not specified.
- 3 sessions per week.
- 12 weeks.
- Randomized controlled trial with 1:1 allocation to supervised high-intensity exercise training plus standard care or standard care alone.
- 50% clot lysis time, Platelet aggregation, Thrombin generation, and Fibrinolysis biomarkers were tracked.
Outcomes
ADP-induced platelet aggregation
No significant between-group difference from baseline to 12 weeks.
Exercise delta -15 AU x min, 95% CI -70 to 40; standard care delta -26 AU x min, 95% CI -77 to 26; p=0.44.
Endogenous thrombin potential
No significant between-group difference from baseline to 12 weeks, although a transient 6-week reduction in exercise was discussed.
Exercise median delta -5%, 95% CI -12 to 3; standard care median delta -6%, 95% CI -13 to 1; p=0.26.
50% clot lysis time
No significant between-group difference from baseline to 12 weeks.
Exercise median delta -9%, 95% CI -23 to 7; standard care median delta -17%, 95% CI -29 to -3; p=0.60.
VO2peak
The exercise training programme was reported to improve VO2peak by about 10% in the exercise group only.
Exact values not provided in this article; the result is cited to a related protocol report.
Insights
- In stable CAD, HIIT may improve cardiorespiratory fitness without necessarily improving haemostasis or fibrinolysis biomarkers.
- Clinical HIIT evidence should preserve screening, supervision, medication context, and exclusion boundaries.
- A familiarisation phase can be important when using demanding whole-body ergometer modalities in older clinical populations.
Limitations
- The exact interval structure and intensity target are not provided in this article.
- Aspirin and other common cardiovascular medications may mask platelet or haemostatic effects.
- Exercise-group completion was lower than standard care completion.
- Stable CAD results may not apply to patients shortly after acute coronary syndrome or revascularisation.
Safety
- No adverse events or injuries were reported in the extracted article text.
- The trial excluded several higher-risk cardiac and pulmonary conditions and anticoagulant treatment.
- All patients gave written informed consent and the Faroese ethical committee approved the study.