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Low-dose
aspirin plus low-dose warfarin may
be life-saving treatment regimens
in cases with severe chronic obstructive
pulmonary disease
Mehmet Rami
Helvaci1, Valeria Pappel2,
Kubra Piral2, Mehpare Camlibel3,
Huseyin Sencan1, Ramazan
Davran4, Mustafa Yaprak1,
Abdulrazak Abyad5,
Lesley Pocock6
(1) Specialist of Internal Medicine,
MD, Turkey
(2) Manager of Writing and Statistics,
Turkey
(3) Specialist of Emergency Medicine,
MD, Turkey
(4) Specialist of Radiology, MD,
Turkey
(5) Middle-East Academy for Medicine
of Aging, MD, Lebanon
(6) medi-WORLD International, Australia
Corresponding author:
Prof Dr Mehmet Rami Helvaci, MD
07400, ALANYA, TurkeyPhone: 00-90-506-4708759
Email:
mramihelvaci@hotmail.com
Received: September 2023. Accepted:
October 2023; Published: November
1, 2023.Citation: Helvaci MR et
al. Low-dose aspirin plus low-dose
warfarin may be life-saving treatment
regimens in cases with severe chronic
obstructive pulmonary disease. World
Family Medicine. November 2023;
21(10): 17-31DOI: 10.5742/MEWFM.2023.95256202
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Abstract
Background:
Sickle cell diseases (SCDs)
are inborn and catastrophic
processes on vascular
endothelium, particularly
at the capillaries.
Methods:
All patients with the SCDs
were included.
Results:
We studied 222 males and 212
females with similar mean
ages (30.8 vs 30.3 years,
p>0.05, respectively).
Beside chronic obstructive
pulmonary disease (COPD) (25.2%
vs 7.0%, p<0.001), smoking
(23.8% vs 6.1%, p<0.001),
alcohol (4.9% vs 0.4%, p<0.001),
transfused red blood cells
(RBCs) in their lives (48.1
vs 28.5 units, p=0.000), disseminated
teeth losses (5.4% vs 1.4%,
p<0.001), ileus (7.2% vs
1.4%, p<0.001), cirrhosis
(8.1% vs 1.8%, p<0.001),
leg ulcers (19.8% vs 7.0%,
p<0.001), digital clubbing
(14.8% vs 6.6%, p<0.001),
coronary heart disease (CHD)
(18.0% vs 13.2%, p<0.05),
chronic renal disease (CRD)
(9.9% vs 6.1%, p<0.05),
and stroke (12.1% vs 7.5%,
p<0.05) were all higher,
and autosplenectomy (50.4%
vs 53.3%, p<0.05) and mean
age of mortality were lower
in males, significantly (30.2
vs 33.3 years, p<0.05).
Conclusion:
The hardened RBCs-induced
capillary endothelial damage
initiates at birth, and terminates
with multiorgan failures even
at childhood in the SCDs.
Parallel to the COPD, all
of the atherosclerotic risk
factors or consequences including
smoking, alcohol, disseminated
teeth losses, ileus, cirrhosis,
leg ulcers, digital clubbing,
CHD, CRD, and stroke were
higher, and autosplenectomy
and mean age of mortality
were lower in males which
cannot be explained by effects
of smoking and alcohol alone
at the younger age. So COPD
may have an atherosclerotic
background, and low-dose aspirin
plus low-dose warfarin may
be life-saving treatment regimens
in severe COPD.
Key
words: Sickle cell diseases,
hardened red blood cells,
capillary endothelial edema,
sudden deaths, chronic obstructive
pulmonary disease, low-dose
warfarin, low-dose aspirin
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