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Minerva Cardioangiologica 2020 Dec 01

DOI: 10.23736/S0026-4725.20.05424-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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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

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