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Coagulation factor VIII is vital for increasing global coagulation after physical exercise

Ljungkvist, Marcus LU ; Olofsson, Henric; Funding, Eva; Berntorp, Erik LU and Zetterberg, Eva LU (2019) In Haemophilia 25(2). p.86-93
Abstract

Background: In a previous smaller study, we found evidence of a diminished global coagulation capacity after maximal exercise in patients with severe haemophilia A (HA). Aim: To validate these results, we repeated the study in a larger cohort. We also examined if the exercise-induced increased levels of von Willebrand factor (VWF) might prolong the effect of factor concentrate administered just before exercise. Methods: We studied individual and global coagulation parameters after maximal physical exercise in 10 persons with severe HA and 10 healthy matched control subjects. Blood samples were taken before, 10 minutes, 60 minutes and 4 hours after exercise. Results: Rotational thromboelastometry (ROTEM) and thrombin generation... (More)

Background: In a previous smaller study, we found evidence of a diminished global coagulation capacity after maximal exercise in patients with severe haemophilia A (HA). Aim: To validate these results, we repeated the study in a larger cohort. We also examined if the exercise-induced increased levels of von Willebrand factor (VWF) might prolong the effect of factor concentrate administered just before exercise. Methods: We studied individual and global coagulation parameters after maximal physical exercise in 10 persons with severe HA and 10 healthy matched control subjects. Blood samples were taken before, 10 minutes, 60 minutes and 4 hours after exercise. Results: Rotational thromboelastometry (ROTEM) and thrombin generation assay-calibrated automated thrombogram (TGA-CAT) showed significantly increased coagulation capacity after maximal exercise in healthy controls but not in patients with severe HA. VWF antigen and activity levels increased significantly in both groups, whereas FVIII:C only showed a significant increase in the control group. No statistically significant differences were seen between FVIII pharmacokinetic results obtained with and without exercise. Conclusion: Our findings do not support the presence of a FVIII-independent mechanism that increases global coagulation, but rather underscores the importance of FVIII in mediating the increased coagulation capacity seen after exercise. Our results could not support the hypothesis that exercise-induced increased levels of VWF for patients with severe HA lead to a prolonged effect of factor concentrate administered just before exercise.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Haemophilia
volume
25
issue
2
pages
86 - 93
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • scopus:85060332628
ISSN
1351-8216
DOI
10.1111/hae.13652
language
English
LU publication?
yes
id
2eeddca5-1e5e-4148-9785-da74eccc30c8
date added to LUP
2019-02-01 10:58:10
date last changed
2019-06-28 10:28:00
@article{2eeddca5-1e5e-4148-9785-da74eccc30c8,
  abstract     = {<p>Background: In a previous smaller study, we found evidence of a diminished global coagulation capacity after maximal exercise in patients with severe haemophilia A (HA). Aim: To validate these results, we repeated the study in a larger cohort. We also examined if the exercise-induced increased levels of von Willebrand factor (VWF) might prolong the effect of factor concentrate administered just before exercise. Methods: We studied individual and global coagulation parameters after maximal physical exercise in 10 persons with severe HA and 10 healthy matched control subjects. Blood samples were taken before, 10 minutes, 60 minutes and 4 hours after exercise. Results: Rotational thromboelastometry (ROTEM) and thrombin generation assay-calibrated automated thrombogram (TGA-CAT) showed significantly increased coagulation capacity after maximal exercise in healthy controls but not in patients with severe HA. VWF antigen and activity levels increased significantly in both groups, whereas FVIII:C only showed a significant increase in the control group. No statistically significant differences were seen between FVIII pharmacokinetic results obtained with and without exercise. Conclusion: Our findings do not support the presence of a FVIII-independent mechanism that increases global coagulation, but rather underscores the importance of FVIII in mediating the increased coagulation capacity seen after exercise. Our results could not support the hypothesis that exercise-induced increased levels of VWF for patients with severe HA lead to a prolonged effect of factor concentrate administered just before exercise.</p>},
  author       = {Ljungkvist, Marcus and Olofsson, Henric and Funding, Eva and Berntorp, Erik and Zetterberg, Eva},
  issn         = {1351-8216},
  language     = {eng},
  month        = {01},
  number       = {2},
  pages        = {86--93},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {Haemophilia},
  title        = {Coagulation factor VIII is vital for increasing global coagulation after physical exercise},
  url          = {http://dx.doi.org/10.1111/hae.13652},
  volume       = {25},
  year         = {2019},
}