Volume 4, Issue 7
Effects of Two-Component Standard Treatment of Chronic Obstructive Pulmonary Disease on Platelet-Vessel Wall Interaction Component and Coagulation Component of Hemostasis
Pertseva TO, Konopkina LI, Yakovleva VH
Abstract: There is a correlation between the severity of clinical symptoms and ventilation disorders in chronic obstructive pulmonary disease (COPD) patients and degree of blood coagulation system disorders. Patients with severe bronchial obstruction form the most challenging category in terms of disease prognosis. Some reports state that impaired haemostasis in COPD patients can be corrected with both anti-inflammatory agents and bronchodilators. However, the effects of medications commonly administered to treat COPD on haemostasis remain understudied.
Aim: to evaluate the effects of adequate two-component standard treatment on platelet-vessel wall interaction and coagulation status of patients with severe COPD in view of severity of systemic inflammation.
Materials and methods. We have examined 30 patients with severe COPD (FEV1<50% pred.) in a stable phase. Prior to inclusion in the study, patients did not receive any adequate therapy with inhaled glucocorticosteroids (IGCS) or long-acting bronchodilators, or a combination thereof. All patients were screened twice – at baseline and two months after assignment of adequate standard therapy. Patients’ complaints and disease history were carefully reviewed, objective data were collected, and functional and blood tests to assess hemorheology status and severity of systemic inflammatory were performed at baseline (Visit 1). COPD treatment was corrected for all patients during this visit: two-component therapy with salmeterol and fluticasone propionat in a fixed combination. After two months (Visit 2), in addition to re-evaluation of clinical symptoms, pulmonary ventilation function was measured, laboratory tests were performed and therapy compliance was assessed for all patients.
Results. Since there no adequate standard treatment is available for COPD patients disorders develop in both platelet-vessel wall interaction and coagulation parts of haemostasis. Use of two-component standard treatment for two months helps stabilise the extrinsic pathway of the coagulation cascade, reduce platelet adhesion activity and decrease systemic inflammation, and has no effect on other parameters of the coagulation component of haemostasis.
Conclusion. Adequate standard treatment of patients with severe COPD helps stabilise disorders of the coagulation part of haemostasis in the extrinsic coagulation pathway and causes no effects on the platelet-vessel wall interaction component of haemostasis.
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