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Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) / SURESH PILLAI

Swansea University Author: SURESH PILLAI

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DOI (Published version): 10.23889/SUthesis.66242

Abstract

Introduction: Chronic obstructive pulmonary disease is an inflammatory condition of the lungs characterised by irreversible airway obstruction and impairment of gas exchange. Acute exacerbation is associated with an increased incidence of venous thromboembolism. The main aim of the study was to inve...

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Published: Swansea, Wales, UK 2024
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: Evans, Phillip A. ; Hawkins, Karl,
URI: https://cronfa.swan.ac.uk/Record/cronfa66242
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spelling v2 66242 2024-05-02 Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) 8aaea9546351c31ee21f473e4fd0459d SURESH PILLAI SURESH PILLAI true false 2024-05-02 Introduction: Chronic obstructive pulmonary disease is an inflammatory condition of the lungs characterised by irreversible airway obstruction and impairment of gas exchange. Acute exacerbation is associated with an increased incidence of venous thromboembolism. The main aim of the study was to investigate whether patients with acute exacerbation were thrombogenic utilising the functional biomarker of clot microstructure, the fractal dimension (df). Methodology: The study recruited 30 stable patients from the chest clinic and 85 patients with acute exacerbation from the Emergency Department of a tertiary teaching hospital. One sample of blood was taken from stable group. Acute exacerbation group had four sampling points at 0 hours, 4-6 hours, 24 hours and 3-7 days. Results: The biomarker, df was significantly elevated in patients presenting with acute exacerbation when compared to stable group (1.71 ± 0.06 vs 1.69 ± 0.05, p=0.03). There was no significant increase in df across the four time points (p=0.28) in the acute exacerbation group. All inflammatory markers and fibrinolytic markers such as D-dimer were significantly higher in acute exacerbation group. Those who died during admission in the acute exacerbation group had significantly elevated df when compared to those who survived (1.76 ± 0.03 vs 1.71 ± 0.06, p=0.02) and binary regression analysis showed that df was a significant predictor of mortality (p=0.024). Conclusions: Patients with chronic obstructive pulmonary disease during exacerbation had denser and tighter clot microstructure as demonstrated by significantly elevated df when compared to stable group indicating that they were thrombogenic. This was due to profound inflammatory response and increased fibrin production. However, with appropriate treatments and prophylactic anticoagulation, there was no further increase in df which might explain low incidence of venous thromboembolism during admissions. Therefore, df is a useful biomarker that measures thrombogenicity, effect of treatment and predicts mortality in patients with acute exacerbation. E-Thesis Swansea, Wales, UK copd, clot microatructure, coagulation, thrombogenicily 30 1 2024 2024-01-30 10.23889/SUthesis.66242 COLLEGE NANME COLLEGE CODE Swansea University Evans, Phillip A. ; Hawkins, Karl, Doctoral Ph.D Welsh Centre for Emergency Medicine Research Welsh Centre for Emergency Medicine Research 2024-05-02T14:56:21.2969457 2024-05-02T14:32:59.4163638 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science SURESH PILLAI 1 66242__30239__102cca92ec9a48b889d4ff5df41c8e52.pdf Pillai_Suresh_K_G_PhD_Thesis_Final_Redacted_Signatures.pdf 2024-05-02T14:49:18.9686176 Output 6195866 application/pdf E-Thesis – open access true Copyright: The Author, Suresh Kumar Gopala Pillai, 2024. This thesis is released under the terms of a Creative Commons Attribution 4.0 (CC-BY) license. Third party content is excluded for use under the license terms. true eng https://creativecommons.org/licenses/by/4.0/deed.en
title Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
spellingShingle Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
SURESH PILLAI
title_short Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
title_full Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
title_fullStr Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
title_full_unstemmed Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
title_sort Clot microatructure (dt) as a blomarker and measurement of thrombogenlcity in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
author_id_str_mv 8aaea9546351c31ee21f473e4fd0459d
author_id_fullname_str_mv 8aaea9546351c31ee21f473e4fd0459d_***_SURESH PILLAI
author SURESH PILLAI
author2 SURESH PILLAI
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institution Swansea University
doi_str_mv 10.23889/SUthesis.66242
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hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
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description Introduction: Chronic obstructive pulmonary disease is an inflammatory condition of the lungs characterised by irreversible airway obstruction and impairment of gas exchange. Acute exacerbation is associated with an increased incidence of venous thromboembolism. The main aim of the study was to investigate whether patients with acute exacerbation were thrombogenic utilising the functional biomarker of clot microstructure, the fractal dimension (df). Methodology: The study recruited 30 stable patients from the chest clinic and 85 patients with acute exacerbation from the Emergency Department of a tertiary teaching hospital. One sample of blood was taken from stable group. Acute exacerbation group had four sampling points at 0 hours, 4-6 hours, 24 hours and 3-7 days. Results: The biomarker, df was significantly elevated in patients presenting with acute exacerbation when compared to stable group (1.71 ± 0.06 vs 1.69 ± 0.05, p=0.03). There was no significant increase in df across the four time points (p=0.28) in the acute exacerbation group. All inflammatory markers and fibrinolytic markers such as D-dimer were significantly higher in acute exacerbation group. Those who died during admission in the acute exacerbation group had significantly elevated df when compared to those who survived (1.76 ± 0.03 vs 1.71 ± 0.06, p=0.02) and binary regression analysis showed that df was a significant predictor of mortality (p=0.024). Conclusions: Patients with chronic obstructive pulmonary disease during exacerbation had denser and tighter clot microstructure as demonstrated by significantly elevated df when compared to stable group indicating that they were thrombogenic. This was due to profound inflammatory response and increased fibrin production. However, with appropriate treatments and prophylactic anticoagulation, there was no further increase in df which might explain low incidence of venous thromboembolism during admissions. Therefore, df is a useful biomarker that measures thrombogenicity, effect of treatment and predicts mortality in patients with acute exacerbation.
published_date 2024-01-30T14:56:21Z
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