Effectiveness of homocysteine lowering vitamins in prevention of thrombotic tendency at high altitude area: A randomized field trial

Thrombosis Research
Jyoti KotwalVelu Nair

Abstract

A higher risk of thrombosis has been reported on prolonged stay at high altitude (HAA). Lowering of homocysteine (Hcy) has been found to reduce the risk of venous thrombosis. A randomized field trial was conducted with primary question whether Hcy lowering agents have any effect on the incidence of thrombosis at HAA amongst Indian soldiers as compared to existing interventions. All units freshly inducted to HAA were randomized into intervention (Vit B12 1000 microgram/day, B6 3mg/day & folic acid 5mg/day) and control arms, with a sample size of 12,000 person-years in each arm. At the end of one year stay at HAA, Folate and B 12 levels decreased significantly in control arm. The levels of Hcy, fibrinogen and plasminogen activator inhibitor (PAI 1) were lower and nitric oxide higher in intervention arm as compared to control arm (p<0.05). At the end of 2years, 5 thrombotic episodes occurred in the intervention arm and 17 in control arm with RR of 0.29 (95% CI 0.11-0.80), attributable fraction % (AFe) 70.59%, Population attributable risk percent 54.55% and Protective Fraction 240%. Intervention with B12 and folic acid is effective in reducing Hcy, PAI 1, fibrinogen levels and increasing NO levels at 1yr as compared to control arm ...Continue Reading

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Citations

Apr 24, 2019·The Cochrane Database of Systematic Reviews·Daniel Molano FrancoIngrid Arevalo-Rodriguez
Mar 13, 2018·The Cochrane Database of Systematic Reviews·Alejandro Gonzalez GarayIngrid Arevalo-Rodriguez
Aug 28, 2020·Advances in Therapy·Alan D KayeChristopher G Kevil
Jun 28, 2017·The Cochrane Database of Systematic Reviews·Víctor H Nieto EstradaIngrid Arevalo-Rodriguez
Jan 29, 2019·Clinical and Experimental Hypertension : CHE·Gang LiJuan Du
Oct 2, 2020·The Journal of Nutrition·Sally P Stabler

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