Activation of Coagulation System During Air Travel: a Crossover Study.
From: Department of Vascular Medicine, Academic Medical Center, Amsterdam, Netherlands.
Lancet
- Publish Date: Mar 2006
- ISSN: 1474-547X
- Volume: 367
- Issue: 9513
- Pages: 832-8
- Medium: Internet
- Language: English
- Citation (JAMA): Schreijer A J M, Cannegieter S C, Meijers J C M, et al. Activation of Coagulation System During Air Travel: a Crossover Study.. Lancet Mar 2006;367:832-8
Abstract
BACKGROUND: There is an increased risk of venous thrombosis after air travel, but the underlying mechanism is unclear. Our aim was to ascertain whether flying leads to a hypercoagulable state. METHODS: We did a crossover study in 71 healthy volunteers (15 men, 56 women), in whom we measured markers of activation of coagulation and fibrinolysis before, during, and after an 8-h flight. The same individuals participated in two control exposure situations (8-h movie marathon and daily life) to separate the effect of air travel on the coagulation system from those of immobilisation and circadian rhythm. To study the effect of risk factors for thrombosis, we included participants with the factor V Leiden mutation (n=11), those who took oral contraceptives (n=15), or both (n=15), as well as 30 individuals with no specific risk factors. FINDINGS: After the flight, median concentrations of thrombin-antithrombin (TAT) complex increased by 30.1% (95% CI 11.2-63.2), but decreased by 2.1% (-11.2 to 14) after the cinema and by 7.9% (-16.2 to -1.2) after the daily life situation. We recorded a high response in TAT levels in 17% (11 of 66) of individuals after air travel (3% [2 of 68] for movie marathon; 1% [1 of 70] in daily life). These findings were most evident in the group with the factor V Leiden mutation who used oral contraceptives. We noted a high response in all variables (prothrombin fragment 1 and 2, TAT, and D-dimer) in four of 63 (6.3%) volunteers after the flight, but in no-one after either of the control situations. INTERPRETATION: Activation of coagulation occurs in some individuals after an 8-h flight, indicating an additional mechanism to immobilisation underlying air travel related thrombosis.
Mesh Headings (Keywords): Adult, Aircraft, Blood Coagulation, Contraceptives, Oral, Cross-Over Studies, Factor V, Female, Humans, Immobilization, Life Style, Male, Netherlands, Risk Factors, Travel, Venous Thrombosis
Check for Full Text / PubMed Unique Identifier (PMID): 16530577
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