Quantification of the 5-Year Incidence of Thromboembolic Events in U.S. Air Force Academy Cadets in Comparison to the U.S. Naval and Military Academies

Smallman, Darlene P.; McBratney, Colleen M; Olsen, Cara; Slogic, Katherine M.; Henderson, Chance J.

doi:10.7205/milmed-d-10-00144

Cited by 16 publications

(11 citation statements)

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“…28 Recently, it was reported that spending time even at moderate altitude was a potential risk factor for thrombosis. 29 The origin of circulating nucleosomes released by hypoxia is unknown, but because chromatin is both pro-coagulant and pro-thrombotic, 8,9 it is plausible that it contributes to the higher incidence of thrombosis in hypoxic conditions. This observation led us to postulate that ischemia may similarly result in the generation of extracellular chromatin that in the case of stroke may worsen brain injury.…”

Section: Discussionmentioning

confidence: 99%

Extracellular Chromatin Is an Important Mediator of Ischemic Stroke in Mice

Meyer

Suidan

Fuchs

et al. 2012

ATVB

161

149

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Objective Recently, a growing number of studies have revealed a pro-thrombotic and cytotoxic role for extracellular chromatin. Cerebral ischemia/reperfusion injury is characterized by a significant amount of cell death and neutrophil activation, both of which may result in the release of chromatin. The goal of this study was to assess the effect of extracellular chromatin in ischemic stroke using a mouse model of transient middle cerebral artery occlusion. Methods and results Similar to reports in stroke patients, we observed increased levels of circulating nucleosomes and DNA after ischemic stroke in mice. In addition, we observed that general hypoxia also augmented extracellular chromatin. We hypothesized that targeting extracellular chromatin components would be protective in ischemic stroke. Indeed, treatment with recombinant human DNase 1 significantly improved stroke outcome. Neutralization of histones using an anti-histone antibody was also protective as evidenced by smaller infarct volumes, whereas increasing levels of extracellular histones via histone infusion exacerbated stroke outcome by increasing infarct size and worsening functional outcome. Conclusions Our results indicate that extracellular chromatin is generated and is detrimental during cerebral ischemia/reperfusion in mice. Targeting DNA and/or histones may be a new therapeutic strategy to limit injury resulting from ischemic stroke.

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Section: Discussionmentioning

confidence: 99%

Extracellular Chromatin Is an Important Mediator of Ischemic Stroke in Mice

Meyer

Suidan

Fuchs

et al. 2012

ATVB

161

149

View full text Add to dashboard Cite

show abstract

“…84 Moderate altitude exposure has been identified as a potential risk factor for venous thrombosis. 85 At high altitudes, there are increases in the hematocrit (number of erythrocytes), cardiac output, blood flow to the brain, 86,87 and decreases in oxygen and vasoconstrictor response. 88 In addition, blood coagulation may be affected under hypoxic conditions, due to a change in the activity of oxygen-dependent enzymes.…”

Section: Methodsmentioning

confidence: 99%

Thromboelastographic Study of Psychophysiological Stress

Peng

Rhind

2013

Clin Appl Thromb Hemost

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Thromboelastography (TEG) is drawing more attention for clinical and laboratory studies of hemostasis. It has been applied to evaluate the effects of both psychological and physiological stress on whole blood coagulation from the onset of the coagulation cascade through clot formation, to the end with fibrinolysis. We conducted a comprehensive review on the applications of TEG for assessment of different stressors, ranging from physical exercise to emotional situations. The methodology is unique in terms of instrumentation, the methods to activate blood coagulation, the type of blood (citrated vs fresh blood), and study settings (in vitro vs in vivo vs clinical trials). Thromboelastography has most often been used to study the effects of physiological stress. The author's own work and future directions are discussed as well. The review would facilitate future development of TEG for evaluating hemostasis and potential pathological pathways in response to various forms of stress.

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“…The incidence rate for thromboembolic events was significantly greater (more than twice) for USAFA cadets when compared with USNA midshipmen and USMA cadets, suggesting that even moderate altitude might be a risk factor for thromboembolic disease in a population with similar risk factors. 38 Clinical Case Studies for TED at HA Several clinical cases have been reported, which described the occurrence of VTE, portal venous thrombosis, cerebral thrombosis, and other thrombotic disorders after exposure to HA (►Table 1).…”

Section: Incidence Of Vte At Hamentioning

confidence: 99%

Exposure to High Altitude: A Risk Factor for Venous Thromboembolism?

Gupta

Ashraf

2012

Semin Thromb Hemost

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There are several genetic and acquired risk factors for venous thromboembolism. Exposure to high altitude (HA), either during air travel, ascension of mountains, or while engaging in sports activities, has been observed to result in a hypercoagulable state, thus predisposing to thromboembolic events. Although several previous studies have suggested that conditions present at HAs contribute to establish a prothrombotic milieu, published reports are contradictory and the exact underlying mechanism remains poorly understood. Results from HA studies also show that environmental conditions at HA such as hypoxia, dehydration, hemoconcentration, low temperature, use of constrictive clothing as well as enforced stasis due to severe weather, would support the occurrence of thrombotic disorders. The three leading factors of Virchow triad, that is, venous stasis, hypercoagulability, and vessel-wall injury, all appear to be present at HA. In synthesis, the large list of environmental variables suggests that a single cause of HA-induced thromboembolic disorders (TED) may not exist, so that this peculiar phenomenon should be seen as a complex or multifactorial trait. Further investigation is needed to understand the risk of TED at HA as well as the possible underlying mechanisms.

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Quantification of the 5-Year Incidence of Thromboembolic Events in U.S. Air Force Academy Cadets in Comparison to the U.S. Naval and Military Academies

Cited by 16 publications

References 0 publications

Extracellular Chromatin Is an Important Mediator of Ischemic Stroke in Mice

Extracellular Chromatin Is an Important Mediator of Ischemic Stroke in Mice

Thromboelastographic Study of Psychophysiological Stress

Exposure to High Altitude: A Risk Factor for Venous Thromboembolism?

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