Minerva Cardioangiologica 2020 Dec 01

DOI: 10.23736/S0026-4725.20.05424-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Lipid Plaque Burden in NSTE-ACS patients with or without COPD: insights from the SCAP trial

Rossella RUGGIERO ¹, Alessandra SCOCCIA ¹, Matteo SERENELLI ¹, Andrea ERRIQUEZ ¹, Giulia PASSARINI ¹, Matteo TEBALDI ¹, Salvatore BRUGALETTA ², Sean MADDEN ³, Davide BERNUCCI ¹, Rita PAVASINI ¹, Paolo CIMAGLIA ⁴, Elisa MAIETTI ⁵, Gianluca CAMPO ¹, Simone BISCAGLIA ¹ ✉

¹ Centro Cardiologico Universitario, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Ferrara, Italy; ² Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; ³ Infraredx, Inc., Burlington, MA, USA; ⁴ Maria Cecilia Hospital, GVM Care & Research, E.S: Health Science Foundation, Cotignola, Ravenna, Italy; ⁵ Center for Clinical Epidemiology, Department of Medical Science, University of Ferrara, Ferrara, Italy

BACKGROUND: COPD patients have higher recurrence of adverse events and worse prognosis after acute coronary syndrome (ACS). The underlying pathophysiological mechanism is not fully elucidated.
METHODS: In screening for COPD in ACS (SCAP) trial (NCT02324660), ACS patients with smoking habit underwent a predischarge screening procedure to detect undiagnosed chronic obstructive pulmonary disease (UCOPD) confirmed with spirometry at 60 days. Patients were then categorized as UCOPD or no-COPD. In 65 NSTE-ACS patients, we performed near infrared spectroscopy (NIRS) in the culprit and at least one non-culprit vessel (151 vessels overall), and we calculated the SYNTAX I score. Primary endpoint was max lipid core burden index (LCBI) 4 mm. Secondary endpoints were SYNTAX score I and vessel LCBI.
RESULTS: Max LCBI 4 mm and vessel LCBI were significantly higher in the UCOPD compared to the no-COPD group (UCOPD 388±122, no-COPD 264±131, p <0.001; UCOPD 118±50, no-COPD 82±42, p<0.001, respectively). UCOPD patients showed higher max LCBI 4 mm and LCBI vessel both in culprit and non-culprit vessels. SYNTAX score I was comparable between the two groups (UCOPD: 13.5 [5.5-24], no-COPD: 12.5 [5-24.5], p=0.7).
CONCLUSIONS: NSTE-ACS patients with UCOPD showed a higher LCBI compared to those without COPD, while SYNTAX score I was comparable between the two groups.

KEY WORDS: Chronic obstructive pulmonary disease; Non-ST-elevated acute coronary syndrome; Near infrared spectroscopy; Lipid core burden index; Synergy Between PCI with Taxus and Cardiac Surgery (SYNTAX) score