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Alterations in coagulatory and fibrinolytic systems following an ultra-marathon

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Abstract

Purpose

The aim of this study was to examine coagulatory and fibrinolytic responses to the Western States Endurance Run (WSER, June 23 to 24, 2012). The WSER is a 161-km (100 mile) trail foot race through the Sierra Nevada Mountains that involves 6,030 m of climb and 7,001 m of descent.

Methods

We examined 12 men and 4 women [mean (95 % CI), age 44.6 years (38.7–50.6)] who completed the race (24.64 h; range 16.89–29.46). Blood samples were collected the morning before the race, immediately post-race, and 1 (D1) and 2 (D2) days post-race (corresponding to 51–54 h and 75–78 h from the start of the race, respectively). Hypercoagulable state was characterized by prothrombin fragment 1+2 (PTF 1+2) and thrombin–antithrombin complex (TAT). Fibrinolytic state was assessed by plasminogen activator inhibitor antigen (PAI-1 Ag), tissue plasminogen activator antigen (tPA Ag), and d-Dimer. Muscle damage was assessed by serum creatine kinase (CK) and myoglobin concentrations.

Results

Significant (P ≤ 0.05) increases were observed immediately post-race for thrombin generation markers, PTF 1+2 (3.9-fold) and TAT (2.4-fold); markers of fibrinolysis, tPA Ag (4.0-fold), PAI-1 Ag (4.5-fold), and d-Dimer (2.2-fold); and muscle damage markers, CK (154-fold) and myoglobin (114-fold). Most markers continued to be elevated at D1, as seen by PTF 1+2, TAT (1.5- and 1.3-fold increase at D1), and d-Dimer (2.5- and 2.1-fold increase at D1 and D2, respectively). Additionally, PTF 1+2:tPA and TAT:tPA ratios, which assessed balance between coagulation and fibrinolysis, were slightly, but significantly increased at D1 (69 and 36 %) and D2 (19 and 31 %). CK and myoglobin also remained elevated at D1 (54- and 7-fold) and D2 (25- and 2-fold) time points.

Conclusion

The WSER produced extensive muscle damage and activated the coagulation and fibrinolytic systems. Since we observed a slight imbalance response between the two systems, a limited potential for thrombotic episodes is apparent in these highly trained athletes.

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Acknowledgments

The authors would like to thank the Western States Endurance Run Foundation for providing funds to support this research. The authors would also like to thank all of the test subjects for their participation in the study. In addition, we thank Peter Defty and Lauren Phinney for their help in subject recruitment and data collection.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA

    Brian R. Kupchak, Brittanie M. Volk, Laura J. Kunces, William J. Kraemer & Jeff S. Volek

  2. Department of Physical Medicine and Rehabilitation, University of California Davis Medical Center, Sacramento, CA, USA

    Martin D. Hoffman

  3. Department of Veterans Affairs, Northern California Health Care Systems, Mather, CA, USA

    Martin D. Hoffman

  4. School of Medicine (Emeritus), University of California Davis, Davis, CA, USA

    Stephen D. Phinney

Authors
  1. Brian R. Kupchak
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  2. Brittanie M. Volk
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  3. Laura J. Kunces
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  4. William J. Kraemer
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  5. Martin D. Hoffman
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  6. Stephen D. Phinney
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  7. Jeff S. Volek
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Corresponding author

Correspondence to Brian R. Kupchak.

Additional information

Communicated by Fabio Fischetti.

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Kupchak, B.R., Volk, B.M., Kunces, L.J. et al. Alterations in coagulatory and fibrinolytic systems following an ultra-marathon. Eur J Appl Physiol 113, 2705–2712 (2013). https://doi.org/10.1007/s00421-013-2709-5

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  • DOI: https://doi.org/10.1007/s00421-013-2709-5

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