Effect of air travel on exercise-induced coagulatory and fibrinolytic activation in marathon runners

Clin J Sport Med. 2011 Mar;21(2):126-30. doi: 10.1097/JSM.0b013e31820edfa6.


Objective: Air travel and exercise change hemostatic parameters. This study investigated the effect of air travel on exercise-induced coagulation and fibrinolysis in endurance athletes.

Design: A prospective longitudinal study.

Setting: The 114th Boston Marathon (April 19, 2010).

Participants: Forty-one adults were divided into travel (T: 23 participants, living >4-hour plane flight from Boston) and nontravel (C: 18 participants, living <2-hour car trip from Boston) groups.

Independent variables: Age, anthropometrics, vital signs, training mileage, and finishing time were collected.

Main outcome measures: Subjects provided venous blood samples the day before (PRE), immediately after (FINISH), and the day following the marathon after returning home (POST). Blood was analyzed for thrombin-antithrombin complex (TAT), tissue plasminogen activator (t-PA), hematocrit (Hct), and the presence of Factor V Leiden R506Q mutation.

Results: Thrombin-antithrombin complex increased more in T subjects in PRE to FINISH samples (5.0 ± 4.0 to 12.9 ± 15.6 μg/L) than in C subjects (4.0 ± 1.2 to 6.1 ± 1.2 μg/L; P = 0.02 for comparison). The t-PA increased in both the T (5.4 ± 2.3 to 25.1 ± 12.2 ng/mL) and C (5.6 ± 2.0 to 27.7 ± 11.3 ng/mL) groups in PRE to FINISH samples, and this response did not differ between groups (P = 0.23 for comparison). Both groups exhibited similar t-PA and TAT values at POST that were not different than PRE (all P > 0.35). Age was related to the FINISH TAT values in T (r = 0.19; P = 0.04) but not in C (r = 0.03; P = 0.53) subjects.

Conclusions: Results suggest that the combination of air travel and marathon running induces an acute hypercoaguable state; this hemostatic imbalance is exaggerated with increasing age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aircraft*
  • Antithrombin III
  • Blood Coagulation / physiology*
  • Competitive Behavior / physiology
  • Factor V / genetics
  • Female
  • Fibrinolysis / physiology*
  • Hematocrit
  • Humans
  • Male
  • Middle Aged
  • Peptide Hydrolases / blood
  • Physical Endurance / physiology
  • Prospective Studies
  • Running / physiology*
  • Time Factors
  • Tissue Plasminogen Activator / blood
  • Travel*
  • Young Adult


  • antithrombin III-protease complex
  • factor V Leiden
  • Antithrombin III
  • Factor V
  • Peptide Hydrolases
  • Tissue Plasminogen Activator