HYPERCOAGULABILITY STATE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Since there is some clinical evidence that the clinical course of pati ents with chronic obstructive pulmonary disease (COPD) may be complica ted by thrombosis in the pulmonary vessels, we studied whether a hyper coagulability state (HS) does occur in COPD. Plasma levels of prothrom bin F1+2 fragment, a marker of thrombin generation, D-dimer, a marker of in vivo thrombin and plasmin activation, and fibrinogen were measur ed in 37 COPD patients and in 30 controls matched for sex and age. COP D patients had significantly higher values of F1+2 (p = 0.0001) and fi brinogen (p = 0.0005) than healthy subjects. The difference persisted after excluding smoking patients. F1+2 was not correlated with PaO2 (r = 0.02, p >0.05) and PaCO2 (p = 0.12, p >0.05). In six patients with stable COPD and F1+2 greater than 1.65 nM (mean + 2 SD of controls) su bcutaneous calcium-heparin therapy (5000 IU t.i.d. for 15 days) signif icantly reduced F1+2 (p = 0.03) and PaCO2 (p = 0.01). This study shows that COPD patients have an ongoing prothrombotic state which could po tentially account for thrombosis occurring in pulmonary vessels. The e ffect of calcium-heparin treatment on clotting system activation and b lood gas may suggest this treatment as potential candidate for prospec tive study in COPD patients.