Effect of marathon run and air travel on pre- and post-run soluble d-dimer, microparticle procoagulant activity, and p-selectin levels.

D-dimer, microparticles, and p-selectin are venous thrombotic risk markers. Elevated p-selectin is associated with increased cardiovascular events. We examined the effects of exercise and air travel on the markers of vascular risk in marathon runners. Forty-one persons participating in the 114th Boston Marathon (April 19, 2010) were divided into travel (n = 23) and nontravel "control" (n = 18) groups according to whether they lived more than a 4-hour plane flight or less than a 2-hour car trip from Boston. The subjects provided venous blood samples the day before, immediately after, and after returning home the day after the marathon. The blood was analyzed for soluble d-dimer, microparticle procoagulant activity, and p-selectin. D-dimer levels increased more before to immediately after (142 ± 83 to 387 ± 196 ng/mL) in the travel group than in the controls (85 ± 26 to 233 ± 95 ng/mL; p = 0.02). Moreover, 6 travel subjects versus 0 controls had d-dimer values >500 ng/mL after returning home the day after the marathon, the clinical threshold for excluding venous thrombosis (p = 0.03). P-selectin increased with exercise (p <0.01) regardless of travel (p = 0.09) but age was related to p-selectin (p = 0.01) such that older subjects exhibited greater p-selectin values before (r(2) = 0.14; p = 0.02) and after returning home the day after the marathon (r(2) = 0.16, p = 0.01). In conclusion, the combination of exercise and travel increases venous and arterial thrombotic risk. Moreover, the p-selectin levels at rest and after exercise were greater with age. These results might explain the reports of venous thrombosis with air travel after athletic events and the reports of cardiac events in older participants running marathons.