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

Ashraf Fawzy; Nirupama Putcha; 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; SPIROMICS and COPDGene Investigators

doi:10.1186/s12931-018-0717-z

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

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

Ashraf Fawzy, Nirupama Putcha, Laura M Paulin, Carrie P Aaron, Wassim W Labaki, MeiLan K Han, Robert A Wise, Richard E Kanner, Russell P Bowler, R Graham Barr, …

Respiratory research, Vol.19(1), pp.20-20

01/26/2018

DOI: 10.1186/s12931-018-0717-z

PMCID: PMC5787242

PMID: 29373977

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Abstract

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 × 10 /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. ClinicalTrials.gov: NCT01969344 (SPIROMICS) and NCT00608764 (COPDGene).

Comorbidity

Thrombocytosis - epidemiology

Cross-Sectional Studies

Humans

Middle Aged

Male

Pulmonary Disease, Chronic Obstructive - physiopathology

Thrombocytosis - physiopathology

Pulmonary Disease, Chronic Obstructive - epidemiology

Exercise Tolerance - physiology

Aged, 80 and over

Adult

Female

Aged

Outcome Assessment (Health Care) - trends

Pulmonary Disease, Chronic Obstructive - genetics

Thrombocytosis - genetics

Details

Title: Subtitle: Association of thrombocytosis with COPD morbidity: the SPIROMICS and COPDGene cohorts
Creators: Ashraf Fawzy - 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
Nirupama Putcha - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 E Monument St. 5th Floor, Baltimore, MD, 21287, USA
Laura M Paulin - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 E Monument St. 5th Floor, Baltimore, MD, 21287, USA
Carrie P Aaron - Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
Wassim W Labaki - Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
MeiLan K Han - Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
Robert A Wise - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 E Monument St. 5th Floor, Baltimore, MD, 21287, USA
Richard E Kanner - Division of Respiratory, Critical Care and Occupational Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA
Russell P Bowler - Department of Medicine, National Jewish Medical and Research Center, Denver, CO, USA
R Graham Barr - Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
Nadia N Hansel - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 1830 E Monument St. 5th Floor, Baltimore, MD, 21287, USA
SPIROMICS and COPDGene Investigators
Contributors: Alejandro P Comellas (Contributor) - University of Iowa, Internal Medicine
Resource Type: Journal article
Publication Details: Respiratory research, Vol.19(1), pp.20-20
DOI: 10.1186/s12931-018-0717-z
PMID: 29373977
PMCID: PMC5787242
NLM abbreviation: Respir Res
ISSN: 1465-9921
eISSN: 1465-993X
Grant note: R01HL089897, R01HL089856 / NHLBI NIH HHS HHSN268200900019C / NHLBI NIH HHS HHSN268200900020C / NHLBI NIH HHS HHSN268200900015C / NHLBI NIH HHS T32HL007534 / NHLBI NIH HHS K23 ES025781 / NIEHS NIH HHS U01 HL089856 / NHLBI NIH HHS HHSN268200900018C / NHLBI NIH HHS HHSN268200900014C / NHLBI NIH HHS G12 MD007597 / NIMHD NIH HHS K23 HL130627 / NHLBI NIH HHS K24 HL138188 / NHLBI NIH HHS K23 HL123594 / NHLBI NIH HHS HHSN268200900017C / NHLBI NIH HHS P30 ES005605 / NIEHS NIH HHS U01 HL089897 / NHLBI NIH HHS U01 HL137880 / NHLBI NIH HHS R01 HL089856 / NHLBI NIH HHS HHSN268200900013C / NHLBI NIH HHS K24 HL137013 / NHLBI NIH HHS T32 HL007534 / NHLBI NIH HHS P50 MD010431 / NIMHD NIH HHS HHSN268200900016C / NHLBI NIH HHS HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN268200900019C, HHSN268200900020C / NHLBI NIH HHS R01 HL089897 / NHLBI NIH HHS
Language: English
Date published: 01/26/2018
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
Record Identifier: 9984094718602771

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