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Alterations in clot microstructure in acute exacerbations of COPD

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Publicado en:Respiratory Research vol. 26, no. 1 (Dec 2025), p. 323
Autor principal: Pillai, Suresh
Otros Autores: Lawrence, Matthew, Zaldua, Jun-Cezar, Hawkins, Karl, Morris, Keith, Whitley, Janet, Evans, Phillip A.
Publicado:
Nature Publishing Group
Materias:
United Kingdom > UK
Emergency medical care
Microstructural analysis
Fractal geometry
Body mass index
Blood clots
Fractals
Regression analysis
Anticoagulants
Chronic obstructive pulmonary disease
Inflammation
Statistical analysis
Rheology
Length of stay
Thromboembolism
Biomarkers
Hypertension
Lung diseases
Rheological properties
Viscoelasticity
Microstructure
Social
Acceso en línea:Citation/Abstract
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Resumen:BackgroundChronic Obstructive Pulmonary Disease (COPD) patients are prone to thrombogenic events, particularly during exacerbations. Fractal dimension (df), a functional biomarker of clot microstructure is useful in assessing thrombogenicity in other diseases. The aim of this study was to compare the changes in df during acute exacerbation of COPD with stable disease. MethodsThis prospective study recruited 30 patients with stable disease from the chest clinic and 85 patients with acute exacerbations from the Emergency Department. The stable group had blood samples taken at one time point, whilst the exacerbation group were sampled at four time points (0 hours, 4-6 hours, 24 hours and 3-7 days). Biomarkers of inflammation, haemostasis and rheology were determined.ResultsAt presentation, the acute exacerbation group had significantly elevated df when compared to the stable group (1.71 ± 0.06 vs 1.69 ± 0.05, p=0.03) but with no significant changes in df over the four time points (p=0.28) sampled. The patients who died in the acute exacerbation group had significantly elevated df when compared to those who survived (1.76 ± 0.03 vs 1.71 ± 0.06, p=0.02) with additional logistic regression analysis confirming that dfwas a significant predictor of mortality (p=0.024).ConclusionsClot microstructural analysis demonstrates that COPD patients during acute exacerbation are more thrombogenic when compared to those with stable disease. This thrombogenic state is not aggravated with appropriate treatment on admission. Patients who died during exacerbations were in a significantly enhanced thrombogenic state when compared to those who survived as demonstrated by significantly elevated df.
ISSN:1465-9921
1465-993X
DOI:10.1186/s12931-025-03405-4
Fuente:Health & Medical Collection