The effect of compression socks worn during a marathon on hemostatic balance

Abstract

Introduction. Marathon running evokes parallel increases in markers of coagulation and fibrinolysis (i.e. hemostatic activation) immediately following strenuous, endurance exercise such that hemostatic balance is maintained. However, other factors incident to marathon running (i.e. dehydration, travel) may disproportionately activate the coagulatory system, increasing blood clot risk after an endurance event in otherwise healthy individuals. We investigated the effect of compression socks on exercise-induced hemostatic activation and balance in endurance athletes running the 2013 Hartford Marathon. Methods. Adults (n = 20) were divided into compression sock (SOCK; n = 10) and control (CONTROL; n = 10) groups. Age, anthropometrics, vital signs, training mileage and finishing time were collected. Venous blood samples were collected 1 day before, immediately after and 1 day following the marathon for analysis of coagulatory (i.e. thrombin–antithrombin complex [TAT] and D-dimer) and fibrinolytic (i.e. tissue plasminogen activator [t-PA]) factors. Results. Plasma D-dimer, TAT and t-PA did not differ between groups at baseline (p > 0.16). There were no significant group · time interactions (all p ≥ 0.17), however, average t-PA was lower in SOCK (8.9 ± 0.7 ng/mL) than CONTROL (11.2 ± 0.7 ng/mL) (p = 0.04). Average TAT also tended to be lower in SOCK (2.8 ± 0.2 µg/L) than CONTROL (3.4 ± 0.2 µg/L) (p = 0.07). Conclusions. Our results suggest that overall hemostatic activation (both coagulation and fibrinolysis) following a marathon tended to be lower with compression socks. Thus, compression socks do not adversely influence markers of hemostasis, appear safe for overall use in runners and may reduce exercise-associated hemostatic activation in individuals at risk for deep vein thrombosis.

Keywords:

• Endurance exercise
• deep vein thrombosis
• mechanical prophylaxis

Acknowledgements

The present study was funded by Hartford Hospital. The authors gratefully acknowledge the research assistance provided by Lindsay Lorson, Brenda Foxen; and the logistical support provided by Beth Shluger at the Hartford Marathon Foundation.

Declaration of interest

Product sponsorship was provided by 2XU. 2XU was not involved in the study design, collection, analysis, interpretation and writing of the manuscript. PD Thompson is a consultant for AstraZeneca, Merck, The Schering-Plough Corporation, Takeda Pharmaceuticals, Roche and Genomas, and is a member of the speakers’ bureau for Merck, Pfizer, Abbott and AstraZeneca. BA Taylor received honorarium from Amgen for consultation services for pharmacovigilance monitoring board. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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