Evaluating the clinical role of fibrinogen, D-dimer, mean platelet volume in patients with acute exacerbation of COPD

Background: There is limited research on clinical indicators for clinicians to judge the hypercoagulability of COPD patients. Objective: The aim in this study was to evaluate the level changes of fibrinogen (FIB), D-dimer (D-D), and mean platelet volume (MPV) in plasma during the stable phase of chronic obstructive pulmonary disease (COPD), as compared with acute exacerbation of COPD (AECOPD). Methods: A total of 240 patients admitted with COPD in our hospital and 60 healthy people were enrolled in this prospective study using data from August 2016 to August 2017. Patients were allocated to AECOPD or stable COPD group. The levels of white blood cell (WBC) count, absolute neutrophil counts (NEU%), activated partial thromboplastin time (APTT), prothrombin time (PT), and hypoxia inducible factor-1(HIF-1) were detected. The MPV, D-D, and the FIB level were also determined and compared between groups. Results: The WBC count, NEU%, FIB, and D-D were significantly higher in the AECOPD group than in the stable COPD group and the healthy group (P < 0.05), while the MPV, APTT and PT was significantly lower in the AECOPD group than in the stable COPD group and the healthy group (P < 0.05). Additionally, MPV was significantly negatively correlated with WBC count (r=-0.798) and NEU% (r=-0.749) in the AECOPD group (P < 0.05); and the percentage of forced expiratory volume in one second (FEV1 ) in the predicted value was significantly negatively correlated with D-D (r=-0.891) and FIB (r=-0.656) (P <0.05). Conclusion: We demonstrated that, for patients hospitalized for exacerbation of COPD, MPV may indeed be a valid indicator of inflammation and a marker of thrombosis. (C) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study aimed to evaluate the differences in coagulation indicators between the stable phase and acute exacerbation of COPD. The results showed that during acute exacerbation, the levels of white blood cell count, neutrophil count, fibrinogen, and D-dimer were significantly increased, while mean platelet volume, activated partial thromboplastin time, and prothrombin time were significantly decreased. Furthermore, mean platelet volume was negatively correlated with white blood cell count and neutrophil count, and forced expiratory volume in one second was negatively correlated with D-dimer and fibrinogen.