Is Aspirin of Use in Patients with COPD Exacerbations?

Low-dose aspirin may help to curb the risk of death in patients with high platelet counts and chronic obstructive pulmonary disease (COPD) exacerbations, according to a new study.

Increased platelet activation (thrombocytosis) is thought to be associated with increased inflammation, which, in turn, is linked to poor short and long term outcomes in COPD.  

In order to investigate whether thrombocytosis is independently associated with mortality in patients following acute exacerbations of COPD (AECOPD), researchers from the University of Dundee in Scotland conducted a cohort study of 1343 patients hospitalized with AECOPD.  Patients were 40 years or older, diagnosed with COPD, and admitted between 2009 and 2011. 

Researchers used platelet counts obtained upon admission to the hospital to determine which participants had thrombocytosis, and identified which patients were given antiplatelet therapies like low-dose aspirin.
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Of the 1343 patients, 157 had thrombocytosis. The disorder was associated with a 2.37-fold increased rate of in-hospital mortality as well as a 53% increase in 1-year mortality.

Rates of cardiovascular hospitalization were not affected by the presence of thrombocytosis. 

While low-dose aspirin use was not associated with any decrease in in-hospital mortality, it did correlate with a 37% reduced risk of 1-year mortality.

“Antiplatelet therapy was associated with significantly lower 1-year mortality and may have a protective role to play in patients with AECOPD,” researchers concluded.

–Michael Potts

Harrison MT, Short P, Williamson PA, Singanayagam A, Chalmers JD, Schembri S. Thrombocytosis is associated with increased short and long term mortality after exacerbation of chronic obstructive pulmonary disease: a role for antiplatelet therapy? [Published online ahead of print April 17, 2014]. Thorax doi:10.1136/thoraxjnl-2013-203996