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Multicenter Study
. 2025 May:241:108058.
doi: 10.1016/j.rmed.2025.108058. Epub 2025 Mar 25.

Platelet activation and COPD-related clinical and imaging characteristics: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study

Carrie L Pistenmaa  1 , Eric A Hoffman  2 , Martin R Prince  3 , Emlyn Hughes  3 , Stephen Dashnaw  3 , Christian M Lo Cascio  3 , Elizabeth C Oelsner  3 , Wei Shen  3 , Yanping Sun  3 , Hinrich Winther  4 , Jens Vogel-Claussen  4 , Jim M Wild  5 , Russell P Tracy  6 , R Graham Barr  3
Affiliations
Multicenter Study

Platelet activation and COPD-related clinical and imaging characteristics: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study

Carrie L Pistenmaa et al. Respir Med. 2025 May.

Abstract

Introduction: The pulmonary vasculature has been implicated in chronic obstructive pulmonary disease (COPD). Whether platelet activation is associated with COPD-related characteristics is unknown.

Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study enrolled participants with 10+ pack-years with and without COPD from 2 cohort studies. Platelet activation was measured in platelet-free plasma as von Willebrand factor (vWF), beta-thromboglobulin (BTG) and platelet factor 4 (PF4). Phenotyping included spirometry, percent emphysema-950HU, air trapping on computed tomography (CT), low-ventilated lung volume on 3He-magnetic resonance imaging (MRI) and contrast-enhanced MRI pulmonary perfusion on and off oxygen. Linear and logistic regression adjusted for demographics, anthropometry, platelet count, aspirin use, COPD status and cohort; the final model adjusted for smoking, pack-years, oxygen saturation and hypertension.

Results: The 116 with vWF were a mean age of 73.5 ± 7.3 years old, 60 % male, 58 % Non-Hispanic White, 28 % Black, 14 % Hispanic/Latino, 23 % smoked currently and 55 % had COPD. vWF was associated with lower FEV1/FVC (-2.0 %/SD vWF, 95 %CI: -3.5, -0.6), and greater percent low-ventilated lung volume on 3He-MRI (6.5 %/SD vWF, 95 %CI: 1.5, 11.5), CT air trapping (3.2 %/SD vWF, 95 %CI: 1.4, 5.1) and heterogeneity (CV) of pulmonary microvascular blood flow (PMBF) and pulmonary microvascular blood volume (PMBV) on oxygen. Higher BTG and PF4 were associated with greater PMBF and PMBV. There was increased odds of COPD with higher PF4 (final model only: OR 1.8/SD PF4, 95 %CI: 1.01, 3.20).

Conclusions: Platelet activation was associated with measures of small airways disease and pulmonary microvascular perfusion in this sample of smokers with and without COPD.

Keywords: COPD; Imaging in COPD; Platelet activation; Small airways disease.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Carrie Pistenmaa reports financial support was provided by Stony Wold Herbert Fund Inc and National Institutes of Health. Carrie Pistenmaa reports a relationship with Verona Pharma plc that includes: consulting or advisory. Research support paid to their institution from AstraZeneca. Eric A. Hoffman reports financial support was provided by National Institutes of Health. Eric A. Hoffman reports a relationship with VIDA Diagnostics that includes: equity or stocks. Eric A. Hoffman is a founder and share holder of VIDA Diagnostics, a company commercializing lung image analysis software developed, in part, at the University of Iowa. In addition, he is a non-paid member of Siemens Healthineer's Photon Counting CT advisory committee. Hinrich Winther is a shareholder of the Comprehenso GmbH. Jens Vogel-Claussen reports was provided by Institut für Diagn. und Interv. Radiologie, Medizinische Hochschule Hannover. Jens Vogel-Claussen reports a relationship with Institut für Diagn. und Interv. Radiologie, Medizinische Hochschule Hannover that includes: consulting or advisory, funding grants, and speaking and lecture fees. Jim Wild reports financial support was provided by UK Research and Innovation Medical Research Council. Russell Tracy reports financial support was provided by National Institutes of Health. R Graham Barr reports financial support was provided by National Institutes of Health. R Graham Barr reports a relationship with COPD Foundation that includes: board membership and travel reimbursement. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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