Asthma and coagulation: A clinical and pathophysiological evaluation

Abstract

In clinical practice pulmonologists have suspected that pulmonary embolisms occur more often in patients with asthma. To confirm this suspicion, a study was initiated to investigate the incidence of venous thromboembolic events in patients with asthma compared to the general population. In addition, this study aimed to determine if any relationship between asthma and venous thromboembolic events could be attributed to asthma severity, viral infections or the use of asthma medication. The activation of coagulation in asthma was further explored in patients and healthy subjects in an attempt to understand the relationship between asthma and pulmonary embolisms. Results from these studies show that pulmonary embolisms do indeed occur more frequently in patients with asthma as a consequence of an enhanced procoagulant state. Moreover, this procoagulant state is augmented by severe forms of asthma, viral infections (often the cause of an asthma exacerbation) and by the use of oral corticosteroids (central to the treatment of asthma exacerbations and patients with severe asthma). These findings are important, as they should make pulmonologists and general physicians aware of the procoagulant changes that occur in patients with asthma. These results can also be extrapolated to patients with other inflammatory diseases requiring corticosteroid treatment making the results relevant to all physicians treating patients with oral corticosteroids