Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study

BACKGROUND: Laboratory studies suggest that the clotting cascade is activated in fibrotic lungs. Since humans vary in their tendency to clot due to a variety of inherited or acquired defects, we investigated whether a prothrombotic state increases the chance of developing idiopathic pulmonary fibros...

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Main Authors: Navaratnam, Vidya, Fogarty, Andrew W., McKeever, Tricia M., Thompson, Norma, Jenkins, Gisli, Johnson, Simon R., Dolan, Gerard, Kumaran, Maruti, Pointon, Kate, Hubbard, Richard B.
Format: Article
Published: BMJ Publishing Group 2014
Online Access:https://eprints.nottingham.ac.uk/43291/
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author Navaratnam, Vidya
Fogarty, Andrew W.
McKeever, Tricia M.
Thompson, Norma
Jenkins, Gisli
Johnson, Simon R.
Dolan, Gerard
Kumaran, Maruti
Pointon, Kate
Hubbard, Richard B.
author_facet Navaratnam, Vidya
Fogarty, Andrew W.
McKeever, Tricia M.
Thompson, Norma
Jenkins, Gisli
Johnson, Simon R.
Dolan, Gerard
Kumaran, Maruti
Pointon, Kate
Hubbard, Richard B.
author_sort Navaratnam, Vidya
building Nottingham Research Data Repository
collection Online Access
description BACKGROUND: Laboratory studies suggest that the clotting cascade is activated in fibrotic lungs. Since humans vary in their tendency to clot due to a variety of inherited or acquired defects, we investigated whether a prothrombotic state increases the chance of developing idiopathic pulmonary fibrosis (IPF) and/or worsens the prognosis of IPF. METHODS: We recruited 211 incident cases of IPF and 256 age-and sex-matched general population controls and collected data on medical history, medication, smoking habit, blood samples as well as lung function and high-resolution CT scans done as part of routine clinical care. A prothrombotic state was defined as the presence of at least one inherited or acquired clotting defect or marker of fibrinolytic dysfunction. We used logistic regression to quantify the association between a prothrombotic state and IPF adjusted for age, sex, smoking habit and highly sensitive C reactive protein. Cox regression was used to determine the influence of a prothrombotic state on survival. RESULTS: Cases were more than four times more likely than controls to have a prothrombotic state (OR 4.78, 95% CI 2.93 to 7.80; p<0.0001). Cases with a prothrombotic state were also likely to have more severe disease (forced vital capacity <70% predicted) at presentation (OR 10.79, 95% CI 2.43 to 47.91) and had a threefold increased risk of death (HR 3.26, 95% CI 1.09 to 9.75). CONCLUSIONS: People with IPF are more likely to have a prothrombotic state than general population controls and the presence of a prothrombotic state has an adverse impact on survival.
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spelling nottingham-432912024-08-15T15:33:05Z https://eprints.nottingham.ac.uk/43291/ Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study Navaratnam, Vidya Fogarty, Andrew W. McKeever, Tricia M. Thompson, Norma Jenkins, Gisli Johnson, Simon R. Dolan, Gerard Kumaran, Maruti Pointon, Kate Hubbard, Richard B. BACKGROUND: Laboratory studies suggest that the clotting cascade is activated in fibrotic lungs. Since humans vary in their tendency to clot due to a variety of inherited or acquired defects, we investigated whether a prothrombotic state increases the chance of developing idiopathic pulmonary fibrosis (IPF) and/or worsens the prognosis of IPF. METHODS: We recruited 211 incident cases of IPF and 256 age-and sex-matched general population controls and collected data on medical history, medication, smoking habit, blood samples as well as lung function and high-resolution CT scans done as part of routine clinical care. A prothrombotic state was defined as the presence of at least one inherited or acquired clotting defect or marker of fibrinolytic dysfunction. We used logistic regression to quantify the association between a prothrombotic state and IPF adjusted for age, sex, smoking habit and highly sensitive C reactive protein. Cox regression was used to determine the influence of a prothrombotic state on survival. RESULTS: Cases were more than four times more likely than controls to have a prothrombotic state (OR 4.78, 95% CI 2.93 to 7.80; p<0.0001). Cases with a prothrombotic state were also likely to have more severe disease (forced vital capacity <70% predicted) at presentation (OR 10.79, 95% CI 2.43 to 47.91) and had a threefold increased risk of death (HR 3.26, 95% CI 1.09 to 9.75). CONCLUSIONS: People with IPF are more likely to have a prothrombotic state than general population controls and the presence of a prothrombotic state has an adverse impact on survival. BMJ Publishing Group 2014-03 Article PeerReviewed Navaratnam, Vidya, Fogarty, Andrew W., McKeever, Tricia M., Thompson, Norma, Jenkins, Gisli, Johnson, Simon R., Dolan, Gerard, Kumaran, Maruti, Pointon, Kate and Hubbard, Richard B. (2014) Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study. Thorax, 69 (3). pp. 207-215. ISSN 1468-3296 http://thorax.bmj.com/content/69/3/207 doi:10.1136/thoraxjnl-2013-203740 doi:10.1136/thoraxjnl-2013-203740
spellingShingle Navaratnam, Vidya
Fogarty, Andrew W.
McKeever, Tricia M.
Thompson, Norma
Jenkins, Gisli
Johnson, Simon R.
Dolan, Gerard
Kumaran, Maruti
Pointon, Kate
Hubbard, Richard B.
Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study
title Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study
title_full Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study
title_fullStr Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study
title_full_unstemmed Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study
title_short Presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study
title_sort presence of a prothrombotic state in people with idiopathic pulmonary fibrosis: a population-based case-control study
url https://eprints.nottingham.ac.uk/43291/
https://eprints.nottingham.ac.uk/43291/
https://eprints.nottingham.ac.uk/43291/