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 Research Group; COPDGene Investigators

Association of thrombocytosis with COPD morbidity: the SPIROMICS and COPDGene cohorts
Fawzy, Ashraf
Putcha, Nirupama
Paulin, Laura M.
Aaron, Carrie P.
Labaki, Wassim W.
Han, MeiLan K.
Wise, Robert A.
Kanner, Richard E.
Bowler, Russell P.
Barr, R. Graham
Hansel, Nadia N.
SPIROMICS Research Group
COPDGene Investigators
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Respiratory Research
Exacerbations, Dyspnea, Quality of life, Platelet count
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).
Lungs--Diseases, Obstructive
Blood platelets
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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 Research Group, COPDGene Investigators, , Association of thrombocytosis with COPD morbidity: the SPIROMICS and COPDGene cohorts, Columbia University Academic Commons, .

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