Risk of Venous Thromboembolism after Air Travel: Interaction with Thrombophilia and Oral Contraceptives

Ida Martinelli, Emanuela Taioli, Tullia Battaglioli, Gian Marco Podda, Serena Maria Passamonti, Paola Pedotti, Pier Mannuccio Mannucci

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Abstract

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.

Original languageEnglish
Pages (from-to)2771-2774
Number of pages4
JournalArchives of Internal Medicine
Volume163
Issue number22
DOIs
Publication statusPublished - Dec 8 2003

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Air Travel
Thrombophilia
Venous Thromboembolism
Oral Contraceptives
Confidence Intervals
Thrombosis
Odds Ratio
Antithrombin Proteins
Factor V
Protein S
Prothrombin
Homocysteine
Protein C
Mutation
Antibodies
DNA
Genes

ASJC Scopus subject areas

  • Internal Medicine

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Risk of Venous Thromboembolism after Air Travel : Interaction with Thrombophilia and Oral Contraceptives. / Martinelli, Ida; Taioli, Emanuela; Battaglioli, Tullia; Podda, Gian Marco; Passamonti, Serena Maria; Pedotti, Paola; Mannucci, Pier Mannuccio.

In: Archives of Internal Medicine, Vol. 163, No. 22, 08.12.2003, p. 2771-2774.

Research output: Contribution to journalArticle

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AU - Podda, Gian Marco

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AU - Mannucci, Pier Mannuccio

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AB - 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.

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