Role of C-reactive Protein and Mean Platelet Volume in Predicting COPD Severity and its Association with Cardiac Abnormalities among the Southern Indian Population: A Cross-sectional Study

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of disease and mortality worldwide. In individuals with mild-to-moderate COPD, serum C-reactive Protein (CRP) corresponds with disease severity and poor health outcomes. Mean Platelet Volume (MPV) is also linked to an elevated degree of inflammation in the body, as well as the severity and acute exacerbation of COPD.

Aim: To evaluate the relationship between serum CRP levels and MPV and its association with COPD disease severity and the patient’s cardiac abnormality.

Materials and Methods: A cross-sectional study was conducted in the Department of Respiratory Medicine, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India, between January 2015 and January 2016. Study was carried out among 55 patients who were diagnosed with COPD in accordance with Global Initiative for Chronic Obstructive Lung Disease 2014 (GOLD) and who were within the age range of 40-70 years were included in the investigation. Severity of airflow obstruction was confirmed by Spirometry using True Flow Easy on PC sensor Pulmonary Function Test (PFT) machine with bronchodilator reversibility testing, as per Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines 2014 and abnormality was evaluated by clinical and radiological assessment. A 3 mL of blood was collected into a clot vial and sent for analysis of CRP using an immunoassay system based on antigen-antibody reaction and fluorescence technology and MPV using the impedance count technique. Receiver Operating Characteristic (ROC) curve was used to find out the sensitivity and specificity of MPV and CRP levels with cardiac abnormality. The study was statistically analysed by Pearson’s Chi-square test.

Results: Out of total sample, majority (n=25, 45.5%) were between 51-60 years age group and, there were 35 (63.63%) males and 20 (36.37%) females. The mean CRP levels of mild COPD patients were found to be 6.980±0.7328 mg/dL, moderate and severe COPD patients were found to be 7.243±0.5324 mg/dL and 7.550±0.4950 mg/dL, respectively and it was statistically significant (p-value <0.0001). In the present study, the mean CRP levels and mean MPV were found to be significantly higher in patients with cardiac abnormality than the patients without cardiac abnormality (p-value <0.0001).

Conclusion: Finally, it was concluded that systemic inflammation is common in COPD patients and that CRP and MPV are significant COPD biomarkers for assessing disease severity, predicting cardiac abnormalities, and predicting patient prognosis.