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Thorax doi:10.1136/thoraxjnl-2014-205329
  • Editorial

The devastating power of platelets in COPD exacerbations: can aspirin save lives in COPD?

  1. Don D Sin1,2
  1. 1UBC James Hogg Research Center and The Institute for Heart and Lung Health, St Paul's Hospital, Vancouver, British Columbia, Canada
  2. 2Department of Medicine (Pulmonary Division), University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Don D. Sin, St Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia, Canada V6Z 1Y6; don.sin{at}hli.ubc.ca
  • Received 24 February 2014
  • Accepted 7 March 2014
  • Published Online First 17 April 2014

The human and societal burden of COPD is alarming. Despite large reductions in smoking rates across industrialised nations, COPD mortality has increased by 60% over the past 20 years, making it the second leading cause of morbidity and mortality in the USA and elsewhere.1 Most of the COPD-related deaths occur during or shortly following acute exacerbations (or ‘lung attacks’). Unfortunately, severe lung attacks are common, with one in six patients requiring hospitalisation for urgent care each year.2 Despite best therapy, 1 in 12 of these patients will succumb to their disease in hospital.3 Even those who survive will experience persistent morbidity from their recent lung attack and never regain their lost health status. Furthermore, one in three patients will have another lung attack in 6–12 months.3 Regrettably, acute and chronic treatments for COPD are suboptimal. Despite global drug expenditures that exceed $36 billion annually for COPD care,4 none of the currently available drugs reduces mortality or modifies disease progression as defined by …

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