Time of day and short-duration high-intensity exercise influences on coagulation and fibrinolysis

Exercise has been demonstrated to have considerable effects upon haemostasis, with activation dependent upon the duration and intensity of the exercise bout. In addition, markers of coagulation and fibrinolysis have been shown to possess circadian rhythms, peaking within the morning (0600-1200h). Therefore, the time of day in which exercise is performed may influence the activation of the coagulation and fibrinolytic systems. This study aimed to examine coagulation and fibrinolytic responses to short-duration high-intensity exercise when completed at different times of the day. Fifteen male cyclists (VO2max: 60.3 +/- 8.1mlkg(-1)min(-1)) completed a 4-km cycling time trial (TT) on five separate occasions at 0830, 1130, 1430, 1730 and 2030. Venous blood samples were obtained pre- and immediately post-exercise, and analysed for tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin-anti-thrombin complexes (TAT) and D-Dimer. Exercise significantly increased plasma concentrations of TF (p<.0005), TFPI (p<.0006), TAT complexes (p<.0012) and D-Dimer (p<.0003). There was a time-of-day effect in pre-exercise TF (p=.004) and TFPI (p=.031), with 0830 greater than 1730 (p.001), while 1730 was less than 2030h (p=.008), respectively. There was no significant effect of time of day for TAT (p=.364) and D-Dimer (p=.228). Power output, TT time and heart rate were not significantly different between TTs (p>.05); however, percentage VO2max was greater at 1730 when compared to 2030 (p=.04). Due to a time-of-day effect present within TF, peaking at 0830, caution should be applied when prescribing short-duration high-intensity exercise bout within the morning in populations predisposed to hypercoagulability.