Journal Article

Impact of acute exacerbations on platelet reactivity in chronic obstructive pulmonary disease patients

Dorca, Jordi, Roura, Gerard, Santos, Salud, López-Sánchez, Marta, Cequier, Angel, Muñoz-Esquerre, Mariana, Huertas, Daniel, Ferreiro, José Luis, Marcano, Ana Lucrecia, Gómez-Hospital, Joan Antoni

2018

Overview

A higher risk of atherothrombotic cardiovascular events, which are platelet-driven processes, has been described during acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, the relevance of platelet reactivity during AECOPD and whether this is affected by antiplatelet agents are not fully elucidated to date. This study aimed to evaluate whether platelet reactivity is augmented during an exacerbation in COPD patients with and without antiplatelet therapy and its association with systemic inflammatory parameters. Prospective, observational, ex vivo investigation was conducted in consecutive patients suffering an exacerbation of COPD. Platelet reactivity was assessed during AECOPD and at stable state. Platelet function assays included: 1) vasodilator-stimulated phosphoprotein assay expressed as P2Y reactivity index (PRI), 2) multiple electrode aggregometry and 3) optical aggregometry. Systemic inflammatory parameters such as leukocyte count, interleukin-6 and fibrinogen were also assessed. Higher platelet reactivity was observed during AECOPD compared to stability measured by vasodilator-stimulated phosphoprotein (PRI: 75.2%±1.9% vs 68.8%±2.4%, =0.001). This augmented platelet aggregability was also observed in the subset of patients on antiplatelet therapy (PRI: 72.8%±3.1% vs 61.7%±7.5%, =0.071). Consistent findings were observed with all other platelet function tests. Patients with greater enhancement of inflammatory markers during AECOPD were more likely to present a higher increase in platelet reactivity. Platelet reactivity is increased during AECOPD, which may contribute to the augmented cardiovascular risk of these patients. Additionally, the increase in platelet reactivity might be associated with an increment in inflammatory markers during exacerbations.

• Publisher: Dove Medical Press Limited,Dove Medical Press Ltd,Dove Press,Dove Medical Press
• Subject: Adenosine diphosphate / Aged / airflow limitation / Antibiotics / Anticoagulants / antiplatelets agents / Aspirin / Biomarkers - blood / Blood diseases / Blood platelets / Blood Platelets - drug effects / Blood Platelets - metabolism / Cardiac patients / Cardiovascular Diseases - blood / Cardiovascular Diseases - etiology / Care and treatment / Cell Adhesion Molecules - blood / Chronic airflow obstruction / Chronic obstructive lung disease / Chronic obstructive pulmonary disease / Clopidogrel / Collagen / Disease Progression / Electrodes / Female / Fibrin / Fibrinogen / Humans / Inflammation / Inflammation - blood / Inflammation - complications / Inflammation Mediators - blood / Interleukins / Leukocyte Count / Lung diseases / Male / Microfilament Proteins - blood / Middle Aged / Normal distribution / Original Research / Patients / Phosphoproteins - blood / Phosphorylation / platelet activation / Platelet Activation - drug effects / Platelet Aggregation / platelet aggregation inhibitors / Platelet Aggregation Inhibitors - therapeutic use / Platelet Function Tests / Prospective Studies / Pulmonary Disease, Chronic Obstructive - blood / Pulmonary Disease, Chronic Obstructive - complications / Pulmonary Disease, Chronic Obstructive - diagnosis / Respiratory tract diseases / Risk Factors / Statistical analysis / Steroids / Thrombosis / Variance analysis / Vasodilator agents