Acute exacerbation of COPD with pulmonary embolism: A new D-dimer cut-off value

AbdelHalim, Hesham A.; AboElNaga, Heba H

doi:10.1016/j.ejcdt.2017.01.008

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Bialas et al . [ 30 ] found that MLPR detection shows very high accuracy for predicting PE in patients with COPD (sensitivity 100%, specificity 85.7%), and Wang et al . [ 39 ] revealed that PDW is elevated in COPD patients with PE and associated with the risk of PE.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review

Zhong

et al. 2021

PLoS ONE

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Background The prevalence of pulmonary embolism (PE) in the acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) is highly controversial. We conducted a systematic review and meta-analysis to summarize the epidemiology and characteristics of PE with AE-COPD for current studies. Methods We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies published prior to October 21, 2020. Pooled proportions with 95% confidence intervals (95% CIs) were calculated using a random effects model. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals were used as effect measures for dichotomous and continuous variables, respectively. Results A total of 17 studies involving 3170 patients were included. The prevalence of PE and deep vein thrombosis (DVT) in AE-COPD patients was 17.2% (95% CI: 13.4%-21.3%) and 7.1% (95% CI: 3.7%-11.4%%), respectively. Dyspnea (OR = 6.77, 95% CI: 1.97–23.22), pleuritic chest pain (OR = 3.25, 95% CI: 2.06–5.12), lower limb asymmetry or edema (OR = 2.46, 95% CI:1.51–4.00), higher heart rates (MD = 20.51, 95% CI: 4.95–36.08), longer hospital stays (MD = 3.66, 95% CI: 3.01–4.31) were associated with the PE in the AE-COPD patients. Levels of D-dimer (MD = 1.51, 95% CI: 0.80–2.23), WBC counts (MD = 1.42, 95% CI: 0.14–2.70) were significantly higher and levels of PaO2 was lower (MD = -17.20, 95% CI: -33.94- -0.45, P<0.05) in the AE-COPD with PE group. The AE-COPD with PE group had increased risk of fatal outcome than the AE-COPD group (OR = 2.23, 95% CI: 1.43–3.50). Conclusions The prevalence of PE during AE-COPD varies considerably among the studies. AE-COPD patients with PE experienced an increased risk of death, especially among the ICU patients. Understanding the potential risk factors for PE may help clinicians identify AE-COPD patients at increased risk of PE. Prospero registration number CRD42021226568.

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Section: Discussionmentioning

confidence: 99%

The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review

Zhong

et al. 2021

PLoS ONE

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“… 24 , 25 AbdelHalim and AboElNaga reported that COPD patients had significantly higher D-dimer levels, even those with low-probability revised Geneva scores and negative computed tomography pulmonary angiogram findings for pulmonary embolism. 26 In addition, vWF, a key initiator of the clotting cascade, is closely relevant to hypercoagulability and thrombosis. 27 Wedzicha et al found that the acute exacerbation of COPD could cause the increase of IL-6 and then stimulate the increase of Fbg.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of ADAMTS-13 on concealed chronic renal failure in COPD patients

Zeng

Chen

Liang

et al. 2017

COPD

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BackgroundImpaired renal function is often neglected in COPD patients. Considering that COPD patients usually have an ongoing prothrombotic state and systemic inflammation status, we investigated the association among them and explored the predictive value of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13), on concealed chronic renal failure (CRF) in COPD patients.MethodsCOPD patients were recruited from the First Affiliated Hospital of Sun Yat-Sen University between January 2015 and December 2016. Control was selected from contemporaneous hospitalized patients without COPD and matched by age and gender at a ratio of 1:1. Estimated glomerular filtration rate (eGFR) was calculated by using the Chronic Kidney Disease Epidemiology Collaboration formula, and all subjects were categorized as having normal renal function (eGFR ≥60 mL min−1 1.73 m−2) and having concealed CRF (normal serum creatinine while eGFR <60 mL min−1 1.73 m−2). Independent correlates of concealed CRF were investigated by logistic regression analysis, and receiver operating characteristic (ROC) curves were used to determine the predictive value of ADAMTS-13.ResultsIn total, 106 COPD and 106 non-COPD patients were finally recruited, and the incidences of concealed CRF were 19.81% and 7.55%, respectively. ADAMTS-13 (odds ratio [OR] =0.858, 95% CI =0.795–0.926), D-dimer (OR =1.095, 95% CI =1.027–1.169), and C-reactive protein (OR =1.252, 95% CI =1.058–1.480) were significantly associated with concealed CRF. Sensitivity and specificity at an ADAMTS-13 cutoff of 318.72 ng/mL were 100% and 81.2%, respectively. The area under the ROC curve was 0.959.ConclusionProthrombotic state and systemic inflammation status might contribute to explaining the high incidence of concealed CRF in COPD, and plasma ADAMTS-13 levels may serve as a strong predictor.

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Prevalence of pulmonary embolism in patients with acute exacerbations of COPD: A systematic review and meta-analysis

Sato

Hasegawa

Nishida

et al. 2021

The American Journal of Emergency Medicine

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Acute exacerbation of COPD with pulmonary embolism: A new D-dimer cut-off value

Cited by 3 publications

References 15 publications

The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review

The prevalence and clinical features of pulmonary embolism in patients with AE-COPD: A meta-analysis and systematic review

Predictive value of ADAMTS-13 on concealed chronic renal failure in COPD patients

Prevalence of pulmonary embolism in patients with acute exacerbations of COPD: A systematic review and meta-analysis

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