[Prethrombotic state in patients with chronic obstructive pulmonary disease and treatment with heparin]

Several clinical reports have evidenced that chronic obstructive pulmonary disease (COPD) may be complicated by thrombosis in pulmonary vessels. The aim of this study was to investigate the putative prethrombotic state of COPD. Highly sensitive molecular markers of hemostasis, plasma levles of prethrombin F1 + 2 fragment (F1 + 2), granule membrane protein-140 (GMP-140), von Willebrand factor (vWF), Fibrinogen (Fg), and D-dimer fragments (DD) were simultaneously measured in 37 COPD patients and in 20 controls matched for sex and age. The results showed that COPD patients had significantly higher values of F1 + 2(P < 0.001), GMP-140 (P < 0.001), vWF (P < 0.001), Fg (P < 0.005) and DD (P < 0.001) than controls. In 16 patients with stable COPD and F1 + 2 greater than 1.65 nmol/L (mean +2s of control), intra-venose heparin therapy (100 mg qd for 10 days) significantly reduced F1 + 2(P < 0.005), vWF (P < 0.05), GMP-140 (P < 0.05), and PaCO2 (P < 0.05). This study has confirmed that COPD patients have an ongoing prethrombotic state which potentially accounts for thrombosis occurring in pulmonary vessels. The effects of heparin on clotting system activation and blood gas indicate that such treatment may be beneficial to COPD patients.