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Respir Res. 2018 Jan 26;19(1):20. doi: 10.1186/s12931-018-0717-z.

Association of thrombocytosis with COPD morbidity: the SPIROMICS and COPDGene cohorts.

Author information

1
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 E Monument St. 5th Floor, Baltimore, MD, 21287, USA. afawzy1@jhmi.edu.
2
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 E Monument St. 5th Floor, Baltimore, MD, 21287, USA.
3
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
4
Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
5
Division of Respiratory, Critical Care and Occupational Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
6
Department of Medicine, National Jewish Medical and Research Center, Denver, CO, USA.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT01969344 (SPIROMICS) and NCT00608764 (COPDGene).

KEYWORDS:

Dyspnea; Exacerbations; Platelet count; Quality of life

PMID:
29373977
PMCID:
PMC5787242
DOI:
10.1186/s12931-018-0717-z
[Indexed for MEDLINE]
Free PMC Article

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