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Respiratory Research
Published in: Respiratory Research 1/2018

Open Access 01-12-2018 | Research

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

Authors: 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, for the SPIROMICS and COPDGene Investigators

Published in: Respiratory Research | Issue 1/2018

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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).
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Metadata
Title
Association of thrombocytosis with COPD morbidity: the SPIROMICS and COPDGene cohorts
Authors
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
for the SPIROMICS and COPDGene Investigators
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2018
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-018-0717-z

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