COPD and Anticoagulation Therapy: Time for a New Approach?

Chronic obstructive pulmonary disease (COPD) is one of the most challenging chronic disease nowadays due to increased morbidity and mortality, despite the multiple new therapies included in the therapeutic scheme. A possible cause may be insufficient approach to thromboembolic risk in these patients, scientific data being so far insufficient and relatively controversial. Areas covered: anticoagulant therapy is used mainly during severe exacerbations. There are data that have shown that therapy with low weight heparins injectable anticoagulants causes not only a reduction in thromboembolic risk but also an improvement in respiratory function parameters. Expert opinion: a number of COPD phenotypes are more prone to procoagulant status and thrombus formation. A layered approach to COPD patients in terms of antithrombotic prophylaxis is needed. Although current published clinical data have not provided irrefutable evidence, possibly due to the relatively heterogeneous approach to inclusion criteria, the frequent identification of autopsy holes in patients with COPD suggests that the high risk of mortality is due to specific bronchopulmonary changes and pulmonary embolism.