Key result
A 100% increase in urine 11dTxB2 was associated with worse respiratory symptoms, reflected by a 0.77-point higher score on the COPD Assessment Test.
Why the study?
Antiplatelet therapy has been associated with fewer exacerbations and reduced respiratory symptoms in COPD, but whether platelet activation is associated with respiratory symptoms was unknown.
Observational (n=169)
No
In patients with stable moderate-severe COPD, elevated urinary 11dTxB2 (a marker of platelet activation) is associated with worse respiratory symptoms, health status, and quality of life, independent of cardiovascular disease.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for platelet activation in COPD symptoms; prospective trials needed before clinical adoption.
Introduction: Antiplatelet therapy has been associated with fewer exacerbations and reduced respiratory symptoms in chronic obstructive pulmonary disease (COPD). Whether platelet activation is associated with respiratory symptoms in COPD is unknown. Methods: Former smokers with spirometry-confirmed COPD had urine 11-dehydro-thromboxane B2 (11dTxB2), plasma soluble CD40L (sCD40L), and soluble P-selectin (sP-selectin) repeatedly measured during a 6- to 9-month study period. Multivariate mixed-effects models adjusted for demographics, clinical characteristics, and medication use evaluated the association of each biomarker with respiratory symptoms, health status, and quality of life. Results: Among 169 participants (average age 66.5±8.2 years, 51.5% female, 47.5±31 pack years, forced expiratory volume in 1 second percent predicted 53.8±17.1), a 100% increase in 11dTxB2 was associated with worse respiratory symptoms reflected by higher scores on the COPD Assessment Test (β 0.77, 95% confidence interval [CI]: 0.11-1.4) and Ease of Cough and Sputum Clearance Questionnaire β 0.77, 95%CI: 0.38-1.2, worse health status (Clinical COPD Questionnaire β 0.13, 95%CI: 0.03-0.23) and worse quality of life (St George's Respiratory Questionnaire β 1.9, 95%CI: 0.39-3.4). No statistically significant associations were observed for sCD40L or sP-selectin. There was no consistent statistically significant effect modification of the relationship between urine 11dTxB2 and respiratory outcomes by history of cardiovascular disease, subclinical coronary artery disease, antiplatelet therapy, or COPD severity. Conclusions: In stable moderate-severe COPD, elevated urinary11dTxB2, a metabolite of the platelet activation product thromboxane A2, was associated with worse respiratory symptoms, health status, and quality of life.
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Fawzy et al. (2022) conducted an observational in chronic obstructive pulmonary disease (n=169). Urine 11-dehydro-thromboxane B2 (11dTxB2) was evaluated on COPD Assessment Test (CAT) score (β 0.77, 95% CI 0.11-1.4). A 100% increase in urine 11dTxB2 was associated with worse respiratory symptoms, reflected by a 0.77-point higher score on the COPD Assessment Test.
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