Chest
ORIGINAL RESEARCHCOPDThe Effects of Hypoxia on Markers of Coagulation and Systemic Inflammation in Patients With COPD
Section snippets
Materials and Methods
Twenty patients with confirmed COPD19 were recruited from primary and secondary care. All patients had an FEV1 > 50% predicted and were studied when clinically stable, defined as no requirement for antibiotic or oral corticosteroid therapy and no change in respiratory symptoms beyond normal day-to-day variation in the preceding month.20 Patients were excluded from the study if they had known heart disease, malignancy, or any other condition associated with a hypercoagulable state or increased
Results
All 20 recruited patients completed the study. No patients became unwell or had a decrease in oxygen saturation < 88% during the hypoxic challenge period, and no test was abandoned. Patients in the hypoxic challenge and control groups were similar in terms of age, sex, and smoking history (Table 1). Resting baseline heart rate, respiratory rate, and oxygen saturations were similar between groups, as were measures of baseline TAT, VWF:Ag, D-dimer, and IL-6. Although patients in the control group
Discussion
The results of this single-blind placebo-controlled study suggest that a normobaric hypoxic challenge in patients with COPD results in an increase in markers of coagulation activation in association with an increase in a marker of systemic inflammation. Both TAT complex and F1 + 2 are measures of thrombin formation, and are widely used as general markers of coagulation activation.10 The increase in both TAT and F1 + 2 in patients undergoing hypoxic challenge and not those receiving medical air
Acknowledgments
Author contributions: Dr Sabit: contributed to the development and design of this study; collection, analysis, and interpretation of the data; drafting and revision of the manuscript; and approval of the submitted manuscript.
Mr Thomas: contributed to the design of the study and revision of the manuscript.
Dr Shale: contributed to the analysis of data, revision of the manuscript, and generation of funding for the study.
Dr Collins: contributed to development and design of this study and revision
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Funding/Support: This study was supported by a Cardiff and Vale Lung Function Fund and GlaxoSmithKline Global. Dr Sabit was a Cardiff and Vale NHS Trust Clinical Research Fellow.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).