 |
|
Risk of Venous Thromboembolism After Air Travel
Interaction With Thrombophilia and Oral Contraceptives
Ida Martinelli, MD, PhD;
Emanuela Taioli, MD, PhD;
Tullia Battaglioli, MD;
Gian Marco Podda, MD;
Serena Maria Passamonti, MD;
Paola Pedotti, BSc;
Pier Mannuccio Mannucci, MD
Arch Intern Med. 2003;163:2771-2774.
Background Conflicting data are available on air travel as a risk factor for venous thromboembolism. To our knowledge, there are no studies investigating whether individuals with thrombophilia and those taking oral contraceptives are more likely to develop venous thromboembolism during flights than those without these risk factors.
Participants and Methods The study sample consisted of 210 patients with venous thromboembolism and 210 healthy controls. DNA analysis for mutations in factor V and prothrombin genes and plasma measurements of antithrombin, protein C, protein S, total homocysteine levels, and antiphsopholipid antibodies were performed.
Results In the month preceding thrombosis for patients, or the visit for controls, air travel was reported by 31 patients (15%) and 16 controls (8%), with an oddsratio of 2.1 (95% confidence interval, 1.1-4.0). Thrombophilia was present in 102 patients (49%) and 26 controls (12%), and oral contraceptives were used by 48 patients and 19 controls (61% and 27% of those of reproductive age, respectively). After stratification for the presence of air travel and thrombophilia, the odds ratio for thrombosis in individuals with both risk factors was 16.1 (95% confidence interval, 3.6-70.9). Stratification for the presence of air travel and oral contraceptive use gave an odds ratio of 13.9 (95% confidence interval, 1.7-117.5) in women with both risk factors.
Conclusions Air travel is a mild risk factor for venous thromboembolism, doubling the risk of the disease. When thrombophilia or oral contraceptive use is present, the risk increases to 16-fold and 14-fold, respectively, indicating a multiplicative interaction.
From the Angelo Bianchi Bonomi Hemophilia and Thrombosis Center (Drs Martinelli, Battaglioli, Podda, Passamonti, and Mannucci) and Molecular and Genetic Epidemiology Unit (Dr Taioli and Ms Pedotti), Istituto di Ricovero e Cura a Carattere Scientifico, Maggiore Hospital, University of Milan, Milan, Italy. The authors have no relevant financial interest in this article.
RELATED LETTER
Low-Molecular-Weight Heparin or Stockings for Preventing Coach Class Thrombosis?
Daniel J. Brotman and Amir K. Jaffer
Arch Intern Med. 2004;164(22):2500-2501.
EXTRACT
| FULL TEXT
RELATED ARTICLES
Economy Class Syndrome: Too Much Flying or Too Much Sitting?
James E. Dalen
Arch Intern Med. 2003;163(22):2674-2676.
EXTRACT
| FULL TEXT
Venous Thrombosis After Long-haul Flights
Thomas Schwarz, Gabriele Siegert, Wolfram Oettler, Kai Halbritter, Jan Beyer, Roswitha Frommhold, Siegmund Gehrisch, Florian Lenz, Eberhard Kuhlisch, Hans-Egbert Schroeder, and Sebastian M. Schellong
Arch Intern Med. 2003;163(22):2759-2764.
ABSTRACT
| FULL TEXT
Incidence of Air Travel–Related Pulmonary Embolism at the Madrid-Barajas Airport
Esteban Pérez-Rodríguez, David Jiménez, Gema Díaz, Ivan Pérez-Walton, Manuel Luque, Carmen Guillén, Eva Mañas, and Roger D. Yusen
Arch Intern Med. 2003;163(22):2766-2770.
ABSTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Adult patients with Eisenmenger syndrome report flying safely on commercial airlines
Broberg et al.
Heart 2007;93:1599-1603.
ABSTRACT
| FULL TEXT
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration
Vandenbroucke et al.
ANN INTERN MED 2007;147:W-163-W-194.
ABSTRACT
| FULL TEXT
Hormones and cardiovascular health in women
The ESHRE Capri Workshop Group
Hum Reprod Update 2006;12:483-497.
ABSTRACT
| FULL TEXT
Venous Thrombosis: The Role of Genes, Environment, and Behavior
Rosendaal
ASH Education Book 2005;2005:1-12.
ABSTRACT
| FULL TEXT
Low-Molecular-Weight Heparin or Stockings for Preventing Coach Class Thrombosis?
Brotman and Jaffer
Arch Intern Med 2004;164:2500-2501.
FULL TEXT
Frequency of Venous Thromboembolism in Low to Moderate Risk Long Distance Air Travellers: the New Zealand Air Traveller's Thrombosis (NZATT) Study
Clagett
PERSPECT VASC SURG ENDOVASC THER 2004;16:235-236.
ABSTRACT
Prevention of Venous Thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy
Geerts et al.
Chest 2004;126:338S-400S.
ABSTRACT
| FULL TEXT
Risk Factors and Recurrence Rate of Primary Deep Vein Thrombosis of the Upper Extremities
Martinelli et al.
Circulation 2004;110:566-570.
ABSTRACT
| FULL TEXT
OC Users at Increased Risk for VTE When Flying?
JWatch Women's Health 2004;2004:1-1.
FULL TEXT
Air-Travel-Related Venous Thromboembolism
JWatch Emergency Med. 2004;2004:10-10.
FULL TEXT
Are Air Travel and Venous Thrombosis Related?
Journal Watch Cardiology 2004;2004:7-7.
FULL TEXT
Are Air Travel and Venous Thrombosis Related?
JWatch General 2004;2004:2-2.
FULL TEXT
Economy Class Syndrome: Too Much Flying or Too Much Sitting?
Dalen
Arch Intern Med 2003;163:2674-2676.
FULL TEXT
|
