Biomarkers of coagulative properties in patients admitted with AECOPD.

Abstract

<b>Introduction:</b> Cardiovascular diseases are common in patients with COPD. Endothelial damage secondary to systemic inflammation may help in explaining this. <b>Aims and objectives:</b> The aim was to determine whether biomarkers of endothelial damage and clot resolution predicted major cardiovascular events (MACE) within 36 months in patients with severe COPD. <b>Methods:</b> Biological samples from the CORTICO-COP trial, which included patients admitted with acute exacerbation of COPD. We assessed von Willebrand factor (vWf)-activated (a), vWF-non-active (n) and a fibrin degradation product (X-FIB) vs. time-to-first MACE within 36 months, using multivariable Cox proportional hazards. Interaction with previous MACE was explored. <b>Results:</b> A total of 299/318 persons in the trial had samples available. 132 had a MACE event. No association were observed between the biomarkers and MACE within 36 months: vWf-a: HR 0.85 [95% CI 0.55–1.28], X-FIB: HR 1.06 [95% CI 0.69–1.62], although vWf-n almost reached significance: HR 1.40 [95% CI 0.93–2.10] (figure). Due to a positive interaction, results for vWf-a and vWf-n were stratified according to previous MACE event. For patients with previous MACE, vWf-a had a HR of 0.48 [95% CI 0.26–0.89]) for future MACE. <b>Conclusion:</b> In COPD patients having an AECOPD, vWf-n seemed associated with future MACE, although this association was not quite significant. Explanations include Type II error hiding a real association and residual confounding.