Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: Protocol of a randomised controlled proof-of-concept trial (APPLE COPD-

This paper described the design of a randomized controlled proof-of-concept study that will evaluate antiplatelet therapy (aspirin, ticagrelor, or dual antiplatelet therapy) versus placebo for the primary prevention of cardiovascular disease in patients with COPD. The primary endpoint of the study will be inhibition of ASPI- and ADP-induced platelet function; secondary endpoints will include inflammatory markers, carotid intima-media thickness, non-invasive measures of vascular stiffness, QoL (EQ-5D-5L, SGRQ), and cardiovascular events. Lung function testing will be performed using a Vitalograph Gold Standard bellows spirometer.