Norepinephrine, but not epinephrine, enhances platelet reactivity and coagulation after exercise in humans

The effects of exercise and catecholamineson platelet reactivity or coagulation and fibrinolysis appear to beinconsistent. This may be partly due to the methods employed inprevious studies. In the present study, we investigated the effects ofacute aerobic exercise and catecholamines on the thrombotic status by anovel in vitro method, shear-induced hemostatic plug formation(hemostatometry), using nonanticoagulated (native) blood. Aerobicexercise (60% maximal O₂consumption) was performed by healthy male volunteers for 20 min, andthe effect on platelet reactivity and coagulation was assessed byperforming hemostatometry before and immediately after exercise.Exercise significantly increased shear-induced platelet reactivity,coagulation, and catecholamine levels. The effect of catecholamines onplatelet reactivity and coagulation was assessed in vitro by addingcatecholamines to blood collected in the resting state. The mainfindings of the present study are that elevation of circulatingnorepinephrine at levels that are attained during exercise causesplatelet hyperreactivity and a platelet-mediated enhanced coagulation.This may be a mechanism of an association of aerobic exercise withthrombotic risk.