RT Journal Article SR Electronic T1 Prothrombotic state in patients with stable COPD: an observational study JF ERJ Open Research JO erjor FD European Respiratory Society SP 00297-2021 DO 10.1183/23120541.00297-2021 VO 7 IS 4 A1 Christos Kyriakopoulos A1 Christos Chronis A1 Evaggelia Papapetrou A1 Athina Tatsioni A1 Konstantina Gartzonika A1 Christina Tsaousi A1 Athena Gogali A1 Christos Katsanos A1 Aikaterini Vaggeli A1 Charikleia Tselepi A1 Georgios Daskalopoulos A1 Stavros Konstantopoulos A1 Konstantinos Kostikas A1 Athanasios Konstantinidis YR 2021 UL http://openres.ersjournals.com/content/7/4/00297-2021.abstract AB Background COPD patients have an increased risk of cardiovascular disease and venous thromboembolism.Methods This study aimed to investigate whether patients with stable COPD have a prothrombotic state compared to COPD-free smokers. We conducted an observational study comparing levels of: D-dimers, INR, aPTT, coagulation factors; fibrinogen, FII, FV, FVII, FVIII, FIX, FX and coagulation inhibitors; protein S, proteins C and antithrombin between stable COPD patients and control subjects.Results A total of 103 COPD patients and 42 controls with similar age, sex, current smoking status, comorbidity burden and cardiovascular risk met the inclusion criteria. Compared to controls, COPD patients had higher levels of D-dimers (median (interquartile range): 360 (230–600) ng·mL−1 versus 240 (180–400) ng·mL−1, p=0.001), fibrinogen (mean±sd: 399±82 mg·dL−1 versus 346±65 mg·dL−1, p<0.001), FII (122±22% versus 109±19%, p=0.004), FV (131±25% versus 121±19%, p=0.015), FVIII (143±32% versus 122±20%, p<0.001) and FX (111 (94–134)% versus 98 (88–107)%, p=0.002), and lower levels of protein S (95 (85–105)% versus 116 (98–121)%, p<0.001) and antithrombin (94.4±11.5% versus 102.3±13.2%, p=0.001). In the COPD group, patients with more severe airflow limitation and frequent exacerbations had significantly higher levels of FII, FV and FX, whereas patients with higher COPD assessment test score had significantly higher levels of FX and lower levels of protein S.Conclusion Patients with stable COPD exhibited increased levels of key coagulation factors and decreased levels of coagulation inhibitors, namely protein S and antithrombin, compared to COPD-free smokers. Among COPD patients, increased levels of FII, FV and FX and decreased levels of protein S were found in patients with more severe disease.Patients with stable COPD exhibit increased levels of key coagulation factors and decreased levels of coagulation inhibitors, namely protein S and antithrombin, compared to COPD-free smokers, indicating a prothrombotic state in stable COPD https://bit.ly/2VmR1PP