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

and for the SPIROMICS and COPDGene Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

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).

Original languageEnglish
Article number20
JournalRespiratory Research
Volume19
Issue number1
DOIs
Publication statusPublished - 26 Jan 2018

Fingerprint

Thrombocytosis
Chronic Obstructive Pulmonary Disease
Morbidity
Confidence Intervals
Odds Ratio
Platelet Count
Dyspnea
Meta-Analysis
Observational Studies
Longitudinal Studies
Biomedical Research
Linear Models

Keywords

  • Dyspnea
  • Exacerbations
  • Platelet count
  • Quality of life

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Association of thrombocytosis with COPD morbidity : The SPIROMICS and COPDGene cohorts. / and for the SPIROMICS and COPDGene Investigators.

In: Respiratory Research, Vol. 19, No. 1, 20, 26.01.2018.

Research output: Contribution to journalArticle

and for the SPIROMICS and COPDGene Investigators. / Association of thrombocytosis with COPD morbidity : The SPIROMICS and COPDGene cohorts. In: Respiratory Research. 2018 ; Vol. 19, No. 1.
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title = "Association of thrombocytosis with COPD morbidity: The SPIROMICS and COPDGene cohorts",
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).",
keywords = "Dyspnea, Exacerbations, Platelet count, Quality of life",
author = "{and for the SPIROMICS and COPDGene Investigators} and Ashraf Fawzy and Nirupama Putcha and Paulin, {Laura M.} and Aaron, {Carrie P.} and Labaki, {Wassim W.} and Han, {Mei Lan K.} and Wise, {Robert A.} and Kanner, {Richard E.} and Bowler, {Russell P.} and Barr, {R. Graham} and Hansel, {Nadia N.} and Alexis, {Neil E.} and Anderson, {Wayne H.} and Igor Barjaktarevic and Bleecker, {Eugene R.} and Boucher, {Richard C.} and Carretta, {Elizabeth E.} and Christenson, {Stephanie A.} and Comellas, {Alejandro P.} and Cooper, {Christopher B.} and Couper, {David J.} and Criner, {Gerard J.} and Ronald Crystal and Curtis, {Jeffrey L.} and Doerschuk, {Claire M.} and Dransfield, {Mark T.} and Freeman, {Christine M.} and Hastie, {Annette T.} and Hoffman, {Eric A.} and Kaner, {Robert J.} and Kleerup, {Eric C.} and Krishnan, {Jerry A.} and LaVange, {Lisa M.} and Lazarus, {Stephen C.} and Martinez, {Fernando J.} and Meyers, {Deborah A.} and Moore, {Wendy C.} and Newell, {John D.} and Stephen Peters and Cheryl Pirozzi and Oelsner, {Elizabeth C.} and O'Neal, {Wanda K.} and Ortega, {Victor E.} and Robert Paine and Sanjeev Raman and Rennard, {Stephen I.} and Tashkin, {Donald P.} and Wells, {J. Michael} and Woodruff, {Prescott G.}",
year = "2018",
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TY - JOUR

T1 - Association of thrombocytosis with COPD morbidity

T2 - The SPIROMICS and COPDGene cohorts

AU - and for the SPIROMICS and COPDGene Investigators

AU - Fawzy, Ashraf

AU - Putcha, Nirupama

AU - Paulin, Laura M.

AU - Aaron, Carrie P.

AU - Labaki, Wassim W.

AU - Han, Mei Lan K.

AU - Wise, Robert A.

AU - Kanner, Richard E.

AU - Bowler, Russell P.

AU - Barr, R. Graham

AU - Hansel, Nadia N.

AU - Alexis, Neil E.

AU - Anderson, Wayne H.

AU - Barjaktarevic, Igor

AU - Bleecker, Eugene R.

AU - Boucher, Richard C.

AU - Carretta, Elizabeth E.

AU - Christenson, Stephanie A.

AU - Comellas, Alejandro P.

AU - Cooper, Christopher B.

AU - Couper, David J.

AU - Criner, Gerard J.

AU - Crystal, Ronald

AU - Curtis, Jeffrey L.

AU - Doerschuk, Claire M.

AU - Dransfield, Mark T.

AU - Freeman, Christine M.

AU - Hastie, Annette T.

AU - Hoffman, Eric A.

AU - Kaner, Robert J.

AU - Kleerup, Eric C.

AU - Krishnan, Jerry A.

AU - LaVange, Lisa M.

AU - Lazarus, Stephen C.

AU - Martinez, Fernando J.

AU - Meyers, Deborah A.

AU - Moore, Wendy C.

AU - Newell, John D.

AU - Peters, Stephen

AU - Pirozzi, Cheryl

AU - Oelsner, Elizabeth C.

AU - O'Neal, Wanda K.

AU - Ortega, Victor E.

AU - Paine, Robert

AU - Raman, Sanjeev

AU - Rennard, Stephen I.

AU - Tashkin, Donald P.

AU - Wells, J. Michael

AU - Woodruff, Prescott G.

PY - 2018/1/26

Y1 - 2018/1/26

N2 - 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).

AB - 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).

KW - Dyspnea

KW - Exacerbations

KW - Platelet count

KW - Quality of life

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U2 - 10.1186/s12931-018-0717-z

DO - 10.1186/s12931-018-0717-z

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JF - Respiratory Research

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