The Effects of Hypoxia on Markers of Coagulation and Systemic Inflammation in Patients With COPD

Sabit, Ramsey; Thomas, Paul; Shale, Dennis J.; Collins, Peter William; Linnane, S.J.

doi:10.1378/chest.09-2764

Cited by 84 publications

(68 citation statements)

References 26 publications

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“…In the basal state, COPD patients exhibit abnormally high levels of tissue factor (tissue factor pro-coagulant activity) and Factor VIIa [10], and their fibrin clots are resistant to lysis [11]. After 2 h of artificial hypoxaemia, compared to non-hypoxic controls, COPD patients have abnormally elevated levels of circulating thrombin-antithrombin complex and prothrombin activation fragments, with a parallel elevation in interleukin (IL)-6 [12].…”

Section: Coagulopathy and Copdmentioning

confidence: 99%

Comorbidities of COPD

Cavaillès¹,

Brinchault-Rabin²,

Dixmier³

et al. 2013

European Respiratory Review

410

285

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By 2020, chronic obstructive pulmonary disease (COPD) will be the third cause of mortality. Extrapulmonary comorbidities influence the prognosis of patients with COPD. Tobacco smoking is a common risk factor for many comorbidities, including coronary heart disease, heart failure and lung cancer. Comorbidities such as pulmonary artery disease and malnutrition are directly caused by COPD, whereas others, such as systemic venous thromboembolism, anxiety, depression, osteoporosis, obesity, metabolic syndrome, diabetes, sleep disturbance and anaemia, have no evident physiopathological relationship with COPD. The common ground between most of these extrapulmonary manifestations is chronic systemic inflammation.All of these diseases potentiate the morbidity of COPD, leading to increased hospitalisations and healthcare costs. They can frequently cause death, independently of respiratory failure. Comorbidities make the management of COPD difficult and need to be evaluated and treated adequately. @ERSpublications Extrapulmonary comorbidities are common in COPD and influence prognosis; we propose an exhaustive comorbidities review

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Section: Coagulopathy and Copdmentioning

confidence: 99%

Comorbidities of COPD

Cavaillès¹,

Brinchault-Rabin²,

Dixmier³

et al. 2013

European Respiratory Review

410

285

View full text Add to dashboard Cite

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“…Recent studies established that COPD may induce an additional specific pro-thrombotic biological situation, particularly during acute exacerbation of COPD [36,37]. It is worth noting that only one-third of immobilised COPD patients with VTE received thrombosis prophylaxis during immobilisation.…”

Section: Main Limitationsmentioning

confidence: 99%

Clinical presentation and outcome of venous thromboembolism in COPD

Bertoletti¹,

Quenet²,

Mismetti³

et al. 2011

Eur Respir J

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Chronic obstructive pulmonary disease (COPD) is a moderate risk factor for venous thromboembolism (VTE), but neither the clinical presentation nor the outcome of VTE in COPD patients is well known.The clinical presentation of VTE, namely pulmonary embolism (PE) or deep venous thrombosis (DVT), and the outcome at 3 months (death, recurrent VTE or bleeding) were compared between 2,984 COPD patients and 25,936 non-COPD patients included in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry. This ongoing international, multicentre registry includes patients with proven symptomatic PE or DVT.PE was the more frequent VTE presentation in COPD patients (n51,761, 59%). PE presentation was more significantly associated with COPD patients than non-COPD patients (OR 1.64, 95% CI 1.49-1.80). During the 3-month follow-up, mortality (10.8% versus 7.6%), minor bleeding (4.5% versus 2.3%) or first VTE recurrences as PE (1.5% versus 1.1%) were significantly higher in COPD patients than in non-COPD patients. PE was the most common cause of death.COPD patients presented more frequently with PE than DVT. It may explain the worse prognosis of COPD patients, with a higher risk of death, bleeding or VTE recurrences as PE compared with non-COPD patients. Further therapeutic options are needed.

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“…According to Sabit et al hypoxia and systemic inflammation are responsible for pro-coaguable status in COPD, manifesting mainly as the increase of thrombin-antithrombin complex, but not DD concentration [30]. Accordingly, Silva et al found no difference in DD concentration between stable COPD patients and the control subjects [31].…”

Section: Discussionmentioning

confidence: 99%

Non-High Risk PE in the Patients with Acute or Exacerbated Respiratory Disease: The Value of the Algorithm Based on D-Dimer Evaluation and Revised Geneva Score

Szturmowicz¹,

Kacprzak²,

Wyrostkiewicz³

et al. 2015

Advances in Respiratory Medicine

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Introduction: The diagnostic algorithm of non-high risk pulmonary embolism (PE) is based on probability scoring systems and plasma D-dimer (DD) assessment. The aim of the present study was to investigate the efficacy of Revised Geneva Scoring (RGS) and DD testing for the excluding of non-high risk PE, in the patients admitted to the hospital due to acute respiratory diseases. Material and methods:The consecutive patients, above 18 years of age, referred to the department of lung diseases, entered the study. The exclusion criteria were: the pregnancy and the suspicion of high risk PE. Plasma DD was measured with quick ELISA test, VIDAS D-dimer New, bioMerieux, France. Multislice computed tomography angiography was performed in all of the patients. Results: 153 patients, median age 65 (19−88) years entered the study. The probability of PE was: low -in 58 patients (38%), intermediate -in 90 (59%), high -in 5 (3%). DD < 500 ng/ml was found in 12% of patients with low and intermediate probability of PE. PE was recognized in 10 out of 153 patients (7%). None of the patients with DD < 500 ng/ml was diagnosed with PE (NPV 100%). Median DD value was significantly higher in PE patients comparing to non-PE (4500 ng/ml and 1356 ng/ml respectively, p = 0.006). Conclusion: In the group of the patients with acute respiratory symptoms, low or intermediate clinical probability scoring combined with normal DD had a high NPV in excluding PE. Nevertheless, such approach was not very effective, as the increased DD was noted in 88% of the examined population.

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The Effects of Hypoxia on Markers of Coagulation and Systemic Inflammation in Patients With COPD

Cited by 84 publications

References 26 publications

Comorbidities of COPD

Comorbidities of COPD

Clinical presentation and outcome of venous thromboembolism in COPD

Non-High Risk PE in the Patients with Acute or Exacerbated Respiratory Disease: The Value of the Algorithm Based on D-Dimer Evaluation and Revised Geneva Score

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