Effects of exercise on platelet reactivity after myocardial infarction: a randomized clinical trial

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Dalcoquio, Talia Falcao ; dos Santos, Mayara Alves ; Alves, Leandro Silva ; Brito Arantes, Flavia Bittar ; Ferreira-Santos, Larissa ; Pinto Brandao Rondon, Maria Urbana ; Furtado, Remo Holanda M. ; Ferrari, Aline Gehlen ; Genestreti Rizzo, Paulo Roberto ; Salsoso, Rocio ; Franci, Andre ; Baracioli, Luciano Moreira ; de Nazare Nunes Alves, Maria Janieire ; Negrao, Carlos Eduardo ; Nicolau, Jose Carlos

• Document type: Journal article
• Source: PLATELETS; v. N/A, p. 9-pg., 2022-11-16.

Abstract

Exercise training (ET) can lower platelet reactivity in patients with cardiovascular risk factors. However, the effects of ET on platelet reactivity in higher-risk patients is unknown. The aim of this study was to evaluate the effects of ET on platelet reactivity in patients with recent myocardial infarction (MI). Ninety patients were randomly assigned 1 month post-MI to the intervention (patients submitted to a supervised ET program) or control group. All patients were on dual antiplatelet therapy (DAPT). Platelet reactivity by VerifyNow-P2Y(12) (measured by P2Y(12) reaction units - PRU5) test was determined at baseline and at the end of 14 +/- 2 weeks of follow-up at rest (primary endpoint), and multiplate electrode aggregometry (MEA) adenosine diphosphate (ADP) and aspirin (ASPI) tests were performed immediately before and after the maximal cardiopulmonary exercise test (CPET) at the same time points (secondary endpoints). Sixty-five patients (mean age 58.9 +/- 10 years; 73.8% men; 60% ST elevation MI) completed follow-up (control group, n = 31; intervention group, n = 34). At the end of the follow-up, the mean platelet reactivity was 172.8 +/- 68.9 PRU5 and 166.9 +/- 65.1 PRU5 for the control and intervention groups, respectively (p = .72). Platelet reactivity was significantly increased after the CPET compared to rest at the beginning and at the end of the 14-week follow-up (among the intervention groups) by the MEA-ADP and MEA-ASPI tests (p < .01 for all analyses). In post-MI patients on DAPT, 14 weeks of supervised ET did not reduce platelet reactivity. (AU)

• FAPESP's process: 17/24605-0 - Influence of microRNAs in angiogenic and antiangiogenic factors in the pathway of vascular endothelial growth factor in patients with Coronary Artery Disease
• Grantee: Larissa Ferreira dos Santos
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 14/01021-4 - Platelet aggregation and antiaggregation in coronary artery disease patients
• Grantee: José Carlos Nicolau
• Support Opportunities: Research Projects - Thematic Grants