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.
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Nature Publishing Group
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LEADER 00000nab a2200000uu 4500
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022 |a 1465-9921 
022 |a 1465-993X 
024 7 |a 10.1186/s12931-025-03405-4  |2 doi 
035 |a 3273085894 
045 2 |b d20251201  |b d20251231 
084 |a 58430  |2 nlm 
100 1 |a Pillai, Suresh  |u Morriston Hospital, Swansea Bay University Health Board, Welsh Centre for Emergency Medicine Research, Emergency Department, Swansea, UK (GRID:grid.416122.2) (ISNI:0000 0004 0649 0266); Swansea University, Medical School, Faculty of Medicine, Health and Life Science, Swansea, UK (GRID:grid.4827.9) (ISNI:0000 0001 0658 8800) 
245 1 |a Alterations in clot microstructure in acute exacerbations of COPD 
260 |b Nature Publishing Group  |c Dec 2025 
513 |a Letter 
520 3 |a 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. 
651 4 |a United Kingdom--UK 
653 |a Emergency medical care 
653 |a Microstructural analysis 
653 |a Fractal geometry 
653 |a Body mass index 
653 |a Blood clots 
653 |a Fractals 
653 |a Regression analysis 
653 |a Anticoagulants 
653 |a Chronic obstructive pulmonary disease 
653 |a Inflammation 
653 |a Statistical analysis 
653 |a Rheology 
653 |a Length of stay 
653 |a Thromboembolism 
653 |a Biomarkers 
653 |a Hypertension 
653 |a Lung diseases 
653 |a Rheological properties 
653 |a Viscoelasticity 
653 |a Microstructure 
653 |a Social 
700 1 |a Lawrence, Matthew  |u Morriston Hospital, Swansea Bay University Health Board, Welsh Centre for Emergency Medicine Research, Emergency Department, Swansea, UK (GRID:grid.416122.2) (ISNI:0000 0004 0649 0266) 
700 1 |a Zaldua, Jun-Cezar  |u Morriston Hospital, Swansea Bay University Health Board, Welsh Centre for Emergency Medicine Research, Emergency Department, Swansea, UK (GRID:grid.416122.2) (ISNI:0000 0004 0649 0266) 
700 1 |a Hawkins, Karl  |u Swansea University, Medical School, Faculty of Medicine, Health and Life Science, Swansea, UK (GRID:grid.4827.9) (ISNI:0000 0001 0658 8800) 
700 1 |a Morris, Keith  |u Cardiff Metropolitan University, School of Applied Science, Cardiff, UK (GRID:grid.47170.35) (ISNI:0000 0001 2034 1556) 
700 1 |a Whitley, Janet  |u Morriston Hospital, Swansea Bay University Health Board, Welsh Centre for Emergency Medicine Research, Emergency Department, Swansea, UK (GRID:grid.416122.2) (ISNI:0000 0004 0649 0266) 
700 1 |a Evans, Phillip A.  |u Morriston Hospital, Swansea Bay University Health Board, Welsh Centre for Emergency Medicine Research, Emergency Department, Swansea, UK (GRID:grid.416122.2) (ISNI:0000 0004 0649 0266) 
773 0 |t Respiratory Research  |g vol. 26, no. 1 (Dec 2025), p. 323 
786 0 |d ProQuest  |t Health & Medical Collection 
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856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3273085894/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3273085894/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch