Abstract
Rationale:Patients with severe asthma have increased risk of pulmonary embolism. It has been shown that these patients have increased procoagulant factors and reduced fibrinolytic activity in induced sputum. We aimed to investigate whether systemic haemostatic activity is increased in patients with severe asthma as compared with patients with mild asthma and healthy control subjects.
Methods:Blood samples from 36 patients with asthma (14 mild, 16 moderate, 6 severe) and 14 healthy subjects (non-atopic, no airway hyperresponsiveness) were analysed. All patients with asthma were atopic and had airway hyperresponsiveness. Asthma severity was defined according to GINA 2006. Coagulation parameters (von Willebrand factor (vWF), thrombin-antithrombin complex (TATc), plasmin-antiplasmin complex (PAPc), plasminogen activator inhibitor type-1 (PAI-1) and D-dimer) were measured in plasma and compared between the 4 groups. One-way ANOVA with post hoc Bonferroni test was used.
Results:The overall ANOVA test showed no difference between the groups for vWF, PAPc, and D-dimer. However, there were significant differences for TATc (p<0,001) and PAI-1 (p=0,040). Table 1 shows the median of TATc and PAI-1 levels in the 4 different groups.
Conclusion: Patients with more severe asthma have increased TATc and PAI-1 levels in plasma. These results suggest that asthma severity induces systemic haemostatic activity which may explain the increased risk of thromboembolic events.
- © 2014 ERS