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

Chun Yin; Yanhui Wang; Chunhua Mo; Zong Yue; Yihong Sun; Dayi Hu

doi:10.1186/s12872-022-02486-z

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

BMC Cardiovasc Disord. 2022 Mar 4;22(1):87. doi: 10.1186/s12872-022-02486-z.

Authors

Chun Yin^{1

2}, Yanhui Wang³, Chunhua Mo¹, Zong Yue³, Yihong Sun⁴, Dayi Hu⁵

Affiliations

¹ Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing, 400016, China.
² Department of Cardiology, Chongqing General Hospital, Chongqing, 401147, China.
³ Cardiac Rehabilitation Center, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, 100026, China.
⁴ Department of Cardiology, China-Japan Friendship Hospital, Beijing, 100029, China.
⁵ Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing, 400016, China. Dayi_hu@sina.cn.

Abstract

Background: 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.

Methods: 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.

Results: All patients completed the CPET without provoked cardiac events, and the mean value of peak oxygen uptake (Peak Vo₂) 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.

Conclusion: 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.

Trial registration: 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 .

Keywords: Cardiac rehabilitation; Coronary artery diseases; Exercise test; Platelet function.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aspirin / adverse effects
Coronary Artery Disease* / diagnosis
Coronary Artery Disease* / drug therapy
Drug Therapy, Combination
Exercise Test
Female
Humans
Male
Middle Aged
Platelet Aggregation
Platelet Aggregation Inhibitors* / adverse effects
Platelet Function Tests

Substances

Platelet Aggregation Inhibitors
Aspirin