Thrombocytosis has been associated with COPD prevalence and increased all-cause mortality in patients with acute exacerbation of COPD (AECOPD); but whether it is associated with morbidity in stable COPD is unknown. This study aims to determine the association of thrombocytosis with COPD morbidity including reported AECOPD, respiratory symptoms and exercise capacity.
Participants with COPD were included from two multi-center observational studies (SPIROMICS and COPDGene). Cross-sectional associations of thrombocytosis (platelet count ≥350 × 109/L) with AECOPD during prior year (none vs. any), exertional dyspnea (modified Medical Research Council (mMRC) score ≥ 2), COPD Assessment Test (CAT) score ≥ 10, six-minute-walk distance (6MWD), and St. George Respiratory questionnaire (SGRQ) were modeled using multivariable logistic or linear regression. A pooled effect estimate for thrombocytosis was produced using meta-analysis of data from both studies.
Thrombocytosis was present in 124/1820 (6.8%) SPIROMICS participants and 111/2185 (5.1%) COPDGene participants. In meta-analysis thrombocytosis was associated with any AECOPD (adjusted odds ratio [aOR] 1.5; 95% confidence interval [95% CI]: 1.1–2.0), severe AECOPD (aOR 1.5; 95% CI: 1.1–2.2), dyspnea (mMRC ≥ 2 aOR 1.4; 95% CI: 1.0–1.9), respiratory symptoms (CAT ≥ 10 aOR 1.6; 95% CI: 1.1–2.4), and higher SGRQ score (β 2.7; 95% CI: 0.5, 5). Thrombocytosis was also associated with classification into Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D (aOR 1.7 95% CI: 1.2–2.4).
Thrombocytosis was associated with higher likelihood of prior exacerbation and worse symptoms. Platelet count, a commonly measured clinical assay, may be a biomarker for moderate-severe COPD symptoms, guide disease classification and intensity of treatment. Future longitudinal studies investigating the role of platelets in COPD progression may be warranted.
Ferroni P, Basili S, Martini F, Vieri M, Labbadia G, Cordova C, Alessandri C, Gazzaniga PP, Soluble P. Selectin as a marker of platelet hyperactivity in patients with chronic obstructive pulmonary disease. J Investig Med. 2000;48(1):21–7. PubMed
Onder I, Topcu S, Dokmetas HS, Turkay C, Seyfikli Z. Platelet aggregation size and volume in chronic obstructive pulmonary disease. Materia medica Polona Polish journal of medicine and pharmacy. 1997;29(1–4):11–3. PubMed
Sandelin M, Holgersson G, Janson C, Ekman S, Bergqvist M. The prognostic value of anemia, thrombocytosis and leukocytosis at time of diagnosis in patients with non-small cell lung cancer. In: Eur Respiratory Soc. 2011;
Digklia A, Voutsadakis IA. Thrombocytosis as a prognostic marker in stage III and IV serous ovarian cancer. Obstetrics & gynecology science. 2014;57(6):457–63. CrossRef
Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428–46. CrossRefPubMed
Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, Barnes PJ, Fabbri LM, Martinez FJ, Nishimura M, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4):347–65. CrossRefPubMed
Cakmak G, Saglam Z, Saler T, Yenigun M, Ataoglu E, Temiz L, Demir T. Platelets: indicator of inflammation in COPD. International Journal of Medicine and Medical Sciences. 2009;1(5):227–9.
Semenov AV, Romanov YA, Loktionova SA, Tikhomirov OY, Khachikian MV, Vasil’ev SA, Mazurov AV. Production of soluble P-selectin by platelets and endothelial cells. Biochemistry Biokhimiia. 1999;64(11):1326–35. PubMed
Davi G, Basili S, Vieri M, Cipollone F, Santarone S, Alessandri C, Gazzaniga P, Cordova C, Violi F. Enhanced thromboxane biosynthesis in patients with chronic obstructive pulmonary disease. The chronic obstructive bronchitis and Haemostasis study group. Am J Respir Crit Care Med. 1997;156(6):1794–9. CrossRefPubMed
Shigeta A, Tada Y, Tatsumi K. High concentration of plasma soluble CD40 ligand is associated with impaired lung function and alveolar structural destruction. Am J Respir Crit Care Med. 2012;185:A4555.
Erikssen J, Hellem A, Stormorken H. Chronic effect of smoking on platelet count and platelet adhesiveness in presumably healthy middle-aged men. Thromb Haemost. 1977;38(3):606–11. PubMed
Butkiewicz A, Kemona-Chetnik I, Dymicka-Piekarska V, Matowicka-Karna J, Kemona H, Radziwon P. Does smoking affect thrombocytopoiesis and platelet activation in women and men? Advances in medical sciences. 2006;51:123–6. PubMed
Arman M, Payne H, Ponomaryov T, Brill A. Role of Platelets in Inflammation. In: Kerrigan, SW, Moran N, editors. The Non-Thrombotic Role of Platelets in Health and Disease. InTech; 2015. https://doi.org/10.5772/60536.
Yu N, Wei X, Li Y, Deng L, Jin C-W, Guo Y. Computed tomography quantification of pulmonary vessels in chronic obstructive pulmonary disease as identified by 3D automated approach. Medicine. 2016;95(40)
Peinado VI, Barberà JA, Ramírez J, Gómez FP, Roca J, Jover L, Gimferrer JM, Rodriguez-Roisin R. Endothelial dysfunction in pulmonary arteries of patients with mild COPD. American Journal of Physiology-Lung Cellular and Molecular Physiology. 1998;274(6):L908–13. CrossRef
Anderson WH, O'Neal WK, Doerschuk CM, Carretta EE, Couper DJ, Tashkin D, Paine I, Robert CCB, Bleecker ER, Barr R. Short-term stability of pulmonary function and clinical measures in COPD using a cohort from Spiromics (subpopulations and intermediate outcome measures in COPD study). Am J Respir Crit Care Med. 2016:A3515–5.
- Association of thrombocytosis with COPD morbidity: the SPIROMICS and COPDGene cohorts
Laura M. Paulin
Carrie P. Aaron
Wassim W. Labaki
MeiLan K. Han
Robert A. Wise
Richard E. Kanner
Russell P. Bowler
R. Graham Barr
Nadia N. Hansel
for the SPIROMICS and COPDGene Investigators
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II