Prevalence and Clinical Characteristics of Post-Thrombotic Syndrome in High-Altitude–Induced Deep Vein Thrombosis: Experience of a Single Tertiary Care Center from Real-World Settings

Yanamandra, Uday; Boddu, Revanth; Pramanik, Suman; Mishra, Kundan; Kapoor, Rajan; Ahuja, Ankur; Chatterjee, Tathagata; Das, Satyaranjan

doi:10.1089/ham.2020.0053

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…2010 ), in line with results of epidemiological studies indicating that high altitude poses a risk for developing thrombosis (Yanamandra et al. 2020 ). Previous research has indicated that Salvia miltiorrhiza and pseudo-ginseng ( Panax notoginseng ), the two main ingredients of CDDP, are effective in promoting blood circulation and dispersing stasis.…”

Section: Discussionsupporting

confidence: 74%

Compound Danshen Dripping Pill inhibits high altitude-induced hypoxic damage by suppressing oxidative stress and inflammatory responses

Hu¹,

Sun²,

Wang³

et al. 2021

Pharmaceutical Biology

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Section: Discussionsupporting

confidence: 74%

Compound Danshen Dripping Pill inhibits high altitude-induced hypoxic damage by suppressing oxidative stress and inflammatory responses

Hu¹,

Sun²,

Wang³

et al. 2021

Pharmaceutical Biology

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“…Inherited or acquired thromboembolic disorders are major causes of disability and death worldwide. [12][13][14][15] High-altitude exposure is an important risk factor of thromboembolic disorders, [16][17][18][19] such as venous thrombosis, [20][21][22][23] pulmonary thromboembolism, mesenteric vein thrombosis, cerebral vein thrombosis, and deep vein thrombosis (DVT), 16,[24][25][26] due to blood hypercoagulation. Previous research has reported that a 1-year stay at high altitude is associated with a 30-times higher risk of thromboembolic events, including DVT and pulmonary embolism.…”

Section: Regular Articlementioning

confidence: 99%

Hypoxia and low temperature upregulate transferrin to induce hypercoagulability at high altitude

Tang

Liao

et al. 2022

Blood

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Studies have shown significantly increased thromboembolic events at high-altitude. We recently reported that transferrin could potentiate blood coagulation, but the underlying mechanism for high-altitude-related thromboembolism is still poorly understood. Here, we examined the activity and concentration of plasma coagulation factors and transferrin in plasma collected from long-term human residents and short-stay mice exposed to varying altitudes. We found that the activities of thrombin and FXIIa along with the concentrations of transferrin were significantly increased in the plasma of humans and mice at high altitudes. Furthermore, both hypoxia (6% O2) and low temperature (0 °C), two critical high-altitude factors, enhanced hypoxia-inducible factor (HIF)-1a levels to promote the expression of the transferrin gene, whose enhancer region contains HIF-1a binding site, and consequently to induce hypercoagulability by potentiating thrombin and FXIIa. Importantly, thromboembolic disorders and pathological insults in mouse models induced by both hypoxia and low temperature were ameliorated by transferrin interferences, including transferrin antibody treatment, transferrin down-regulation, and the administration of our designed peptides that inhibit the potentiation of transferrin on thrombin and FXIIa. Thus, low temperature and hypoxia up-regulated transferrin expression promoted hypercoagulability. Our data suggest that targeting the transferrin-coagulation pathway is a novel and may be a powerful strategy against thromboembolic events caused by harmful environmental factors under high-altitude conditions.

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“…THBS1, in addition, contributes to pulmonary vascular remodeling through the stimulation of platelet aggregation, a state that may lead to thrombotic complications [ 36 ]. In fact, thrombosis has been identified as one of the serious cardiovascular issues at HA [ 37 ]. It, thus, signifies the importance of THBS1 at HA.…”

Section: Discussionmentioning

confidence: 99%

Hypertensive Patients Exhibit Enhanced Thrombospondin-1 Levels at High-Altitude

Sharma

Chanana

Mohammad

et al. 2021

Life

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Thrombospondin-1 (THBS1) levels elevate under hypoxia and have relevance in several cardiovascular disorders. The association of THBS1 with endothelial dysfunction implies its important role in hypertension. To establish the hypothesis, we screened patients with hypertension and their respective controls from the two different environmental regions. Cohort 1 was composed of Ladakhis, residing at 3500 m above sea level (ASL), whereas Cohort 2 was composed of north-Indians residing at ~200 m ASL. Clinical parameters and circulating THBS1 levels were correlated in the case–control groups of the two populations. THBS1 levels were significantly elevated in hypertension patients of both cohorts; however, the levels were distinctly enhanced in the hypertensive patients of HA as compared to normoxia (p < 0.002). The observation was supported by the receiver operating curve analysis with an area under curve of 0.7007 (0.627–0.774) demonstrating the discriminatory effect of hypobaric hypoxia on the levels as compared to normoxia (p < 0.011). Significant correlation of THBS1 and mean arterial pressure was observed with upraised positive correlations in the hypertensive highlanders as compared to the hypertensive patients from sea-level. The prevalence of differential distribution of THBS1 and CD47 genes variants, their interactions, and association with the THBS1 levels were also determined. Genotype-interactions between THBS1 rs2228263 and CD47 rs9879947 were relevant and the regression analysis highlighted the association of risk genotype-interactions with increased THBS1 levels in hypertension. Genetic studies of additional thrombospondin pathway-related genes suggest the complex role of THBS1 in the presence of its family members and the related receptor molecules at HA.

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Prevalence and Clinical Characteristics of Post-Thrombotic Syndrome in High-Altitude–Induced Deep Vein Thrombosis: Experience of a Single Tertiary Care Center from Real-World Settings

Cited by 6 publications

References 30 publications

Compound Danshen Dripping Pill inhibits high altitude-induced hypoxic damage by suppressing oxidative stress and inflammatory responses

Compound Danshen Dripping Pill inhibits high altitude-induced hypoxic damage by suppressing oxidative stress and inflammatory responses

Hypoxia and low temperature upregulate transferrin to induce hypercoagulability at high altitude

Hypertensive Patients Exhibit Enhanced Thrombospondin-1 Levels at High-Altitude

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