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

Navaratnam, Vidya and Fogarty, Andrew W. and McKeever, Tricia M. and Thompson, Norma and Jenkins, Gisli and Johnson, Simon R. and Dolan, Gerard and Kumaran, Maruti and 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

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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.

Item Type: Article
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
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Depositing User: Claringburn, Tara
Date Deposited: 30 May 2017 15:20
Last Modified: 08 May 2020 09:45

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