title: Platelet activation and cardiovascular comorbidities in patients with chronic obstructive pulmonary disease.
abstract: Objective Platelet activation in COPD patients is associated with an increased risk of cardiovascular events. We aimed at assessing the mean platelet volume (MPV), as an index of platelet activation, in COPD patients both when stable or during acute exacerbation (AE). Research design and methods A total of 478 patients (75 with AE) and 72 age-matched healthy controls were enrolled. Medical history, comorbidities, medications, pulmonary function tests, MPV and blood cell count, erythrocyte sedimentation rate (ERS) and C-reactive protein (CRP) were recorded. Results MPV was higher in COPD than in controls (8.7 ± 1.1 fL and 8.4 ± 0.8 fL respectively, p = 0.025) and increased with the severity of the disease as assessed by post-bronchodilator forced expiratory volume in the first second (FEV1) categorized I to IV (p > 0.05). MPV was higher in COPD patients during AE compared with stable condition (8.7 ± 1.0 fL and 8.9 ± 1.0 fL, p = 0.021). MPV ≥10.5 fL correlated with the presence of at least one co-existing cardiovascular disease (p = 0.008). No correlation was observed between MPV and CRP or ERS in patients or in controls. A negative correlation was found between platelet count and MPV in COPD patients. Limitations The retrospective design did not allow the assessment of a clear cause-effect relationship between MPV and all the pathophysiological factors considered. Conclusions Elevated MPV is associated with lower platelet count and with cardiovascular comorbidity in COPD patients. MPV is higher in more severe COPD and during AE. Present findings warrant future studies to confirm a possible clinically relevant role for platelet activation in cardiovascular risk in the COPD population.
authors.affiliation: a Department of Internal Medicine , University of Brescia and AOU Spedali Civili , Brescia , Italy ;
authors.forename: Mario
authors.initials: M
authors.lastname: Malerba
authors.affiliation: a Department of Internal Medicine , University of Brescia and AOU Spedali Civili , Brescia , Italy ;
authors.forename: Alessia
authors.initials: A
authors.lastname: Olivini
authors.affiliation: b Department of Emergency AOU Spedali Civili , Brescia , Italy ;
authors.forename: Alessandro
authors.initials: A
authors.lastname: Radaeli
authors.affiliation: c Department of Clinical and Biological Sciences , University of Torino, San Luigi Hospital , Orbassano , Italy ;
authors.forename: Fabio Luigi Massimo
authors.initials: FL
authors.lastname: Ricciardolo
authors.affiliation: d Department of Medical and Surgical Sciences , Ospedale Villa Pineta, University of Modena-Reggio Emilia , Modena , Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Clini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D015539:Platelet Activation; D010976:Platelet Count; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000150:complications* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein
keywords: COPD; Cardiovascular comorbidities; Inflammation; Mean platelet volume; Platelet