FEATURES OF ACTIVATION OF TRIPSIN-LIKE PLASMA ENZYMES IN STABLE PATIENTS WITH COPD

Abstract

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: The presence of COPD in patients contributes to an increase in prothrombotic potential and an increased risk of venous thromboembolism. The activity of extracellular proteases of cascade coagulation and fibrinolysis reactions is the main component of the total activity of trypsin-like plasma enzymes (TLE). The aim of the study was to investigate the total activity of TLE (TA TLE) of plasma and to determine the effect of bronchial obstruction, the frequency of exacerbations of COPD, body weight and dyslipidemia in patients with stable COPD on it. METHODS: 54 individuals were included in the study. The I group (G1) included 44 stable patients with COPD A - D who received standard therapy, the II group (G2) included 10 healthy persons. Anthropometry was performed to determine body mass index (BMI), photocolorimetry to determine the TA TLE of plasma, coagulogram, enzymatic colorimetry for determination of total cholesterol (TCh), cholesterol of high density lipoproteins (LHD), cholesterol of low density lipoproteins (LDL), triglycerides (TG), calculation of the level of cholesterol of very low density lipoproteins (VLDL) according to the Friedewald formula, spirometry, for patients with COPD, the frequency of exacerbations of COPD was determined within 1 year. RESULTS: The median age in G1 was (56.0±6.7) years, in G2 was (52.7±4.9) years, BMI in G1 - 26.3 [24.0; 30.3] kg/m2, in G2 – 25.4 [24.3; 26.2] kg/m2. In G1 FEV1 was 51.0 [42.0; 61.0] %, a direct correlation of FEV1 and BMI was found (R=0.36, p=0.016). In G1 the frequency of exacerbations of COPD during the year was (1.9 ± 0.86). The TA TLE of plasma in G1 (76.13 [49.37; 102.18] μmol/l) was significantly higher than in G2 (46.48 [34.17; 50.35] μmol/ /l), p = 0.005. In G1 the TA TLE of plasma was directly associated with an increase in prothrombin index (PTI) (R=0.43, p=0.016), while the PTI in G1 (106.0 [99.0; 109.0] %) was higher than in G2 (98.0 [95.0; 101.0] %), p = 0.48. In patients in G1 the correlation TA TLE with the level of FEV1 has not been established, but a direct correlation has been found with an increase in the frequency of exacerbations of COPD (R = 0.34, p = 0.046), increase in BMI (R = 0.36, p = 0.022) and direct correlation with levels of TCh (R = 0.40, p = 0.014), LDL (R = 0.36, p = 0.029), VLDL (R = 0.43, p = 0.008), TG (R = 0.55, p = 0.0007). CONCLUSIONS: In stable patients with COPD against the background of standard therapy, an increase in the total proteolytic activity of plasma TLE is observed, which is associated with an increase in prothrombotic potential. An increase in TA TLE of plasma is associated with an increase in the frequency of exacerbations of COPD, an increase in BMI and dyslipidemia. CLINICAL IMPLICATIONS: Prevention of thrombotic complications in patients with COPD should include measures to reduce the frequency of exacerbations of COPD, reduce body weight of patients, and correct dyslipidemia. DISCLOSURES: No relevant relationships by Olena Kovalenko, source=Web Response No relevant relationships by Viktoriia Rodionova, source=Web Response