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. 2014;1(2):239-249.
doi: 10.15326/jcopdf.1.2.2014.0133#sthash.pvwPnxaI.dpuf.

Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease

Victor Kim  1 , Nishant Goel  1 , Jinal Gangar  1 , Huaqing Zhao  1 , David E Ciccolella  1 , Edwin K Silverman  2 , James D Crapo  3 , Gerard J Criner  1 ; and the COPD Gene Investigators
Affiliations

Risk Factors for Venous Thromboembolism in Chronic Obstructive Pulmonary Disease

Victor Kim et al. Chronic Obstr Pulm Dis. 2014.

Abstract

Background: COPD patients are at increased risk for venous thromboembolism (VTE). VTE however remains under-diagnosed in this population and the clinical profile of VTE in COPD is unclear.

Methods: Global initiative for chronic Obstructive Lung Disease (GOLD) stages II-IV participants in the COPD Genetic Epidemiology (COPDGene) study were divided into 2 groups: VTE+, those who reported a history of VTE by questionnaire, and VTE-, those who did not. We compared variables in these 2 groups with either t-test or chi-squared test for continuous and categorical variables, respectively. We performed a univariate logistic regression for VTE, and then a multivariate logistic regression using the significant predictors of interest in the univariate analysis to ascertain the determinants of VTE.

Results: The VTE+ group was older, more likely to be Caucasian, had a higher body mass index (BMI), smoking history, used oxygen, had a lower 6-minute walk distance, worse quality of life scores, and more dyspnea and respiratory exacerbations than the VTE- group. Lung function was not different between groups. A greater percentage of the VTE+ group described multiple medical comorbidities. On multivariate analysis, BMI, 6-minute walk distance, pneumothorax, peripheral vascular disease, and congestive heart failure significantly increased the odds for VTE by history.

Conclusions: BMI, exercise capacity, and medical comorbidities were significantly associated with VTE in moderate to severe COPD. Clinicians should suspect VTE in patients who present with dyspnea and should consider possibilities other than infection as causes of COPD exacerbation.

Keywords: COPD; PVD; VTE; peripheral vascular disease; pulmonary embolism; venous thromboembolism.

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Conflict of interest statement

VK has participated in clinical trials sponsored by Boehringer Ingelheim, Glaxo-Smith-Kline, Medimmune, and Roche pharmaceuticals. VK is supported by NHLBI K23HL094696-03. NG, JC, HZ, and DEC have nothing to disclose. EKS received grant support and consulting fees from GlaxoSmithKline for studies of COPD genetics. EKS received grant support from GlaxoSmithKline for studies of COPD genetics, and he received honoraria and consulting fees from AstraZeneca, Merck, and GlaxoSmithKline. GJC has served on Advisory Committees for Boehringer Ingelheim, Ikaria, Holaira, CSA and Amirall. All of these sums are less than $2,500. GJC has received research grants from: Boehringer Ingelheim, Forest, Actelion, Glaxo-Smith-Kline, AstraZeneca, Pearl, Novartis Pharmaceuticals, Pulmonx, PneumRX and Aeris Therapeutics. All research grant monies are deposited and controlled by Temple University.

The COPDGene project is supported by grant awards R01 HL089856 and R01 HL089897 from the NHLBI. The COPDGene project is also supported by the COPD Foundation through contributions made to an Industry Advisory Board comprised of AstraZeneca, Boehringer Ingelheim, Novartis, Pfizer, Siemens and Sunovion.

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