Anti-Platelets in Chronic Obstructive Pulmonary Disease

Inclusion Criteria - COPD Cases:

• COPD (FEV1/FVC < 0.7, FVC >= LLN), GOLD Stage I/II/III (FEV1 >= 40%)

• Current or former smoker of at least 10 pack years

Inclusion Criteria - Controls:

• Normal lung function (FEV1/FVC >= 0.7, FEV1 and FVC >= LLN)

• Current or former smoker of at least 10 pack years

Exclusion Criteria:

• Platelet count < 150,000/dL or self-report of a bleeding disorder;

• Regular use of aspirin, clopidogrel or another antiplatelet medication;

• Allergy to aspirin, clopidogrel, albuterol or iodine/IV contrast;

• BMI > 35;

• History of intracranial hemorrhage, severe GI bleed or other life-threatening bleed;

• Use of blood thinner (e.g. warfarin, lovenox or novel oral anti-coagulants);

• Continuous use of supplemental oxygen at home;

• Regular use of an NSAID;

• Daily use of oral steroids, theophylline, roflumilast, or loop diuretics;

• History of organ transplant or autoimmune disease on systemic therapy (rheumatoidarthritis, lupus);

• Use of a biologic medication with regular injections;

• Other current lung disease (interstitial lung disease, idiopathic pulmonaryfibrosis, asthma);

• IV drug use within the last year;

• History of lung surgery to remove part of the lung;

• Known bullae or advanced destructive emphysema in more than 1/3 of the lungs;

• Treatment for cancer (systemic therapy or surgical/radiation within the thorax) inthe last 12 months;

• Known diagnosis of pulmonary hypertension;

• Known systolic heart failure (RV or LV EF < 40%);

• Acute or chronic renal insufficiency (estimated glomerular filtration rate [GFR] <60mL/min/1.73 m2 or self-report). GFR will be calculated using the CKD-EPI equation;

• Current or planned pregnancy in the next year;

• Regular marijuana smoking;

• Exacerbation of respiratory symptoms within the previous 6 weeks, such as thatrequiring hospitalization, oral prednisone or antibiotics to control symptoms, orlonger and not yet returned to baseline; and

• Chest, abdominal or eye surgery, or a heart attack or stroke, within the last 3months.