Impact of Spirometrically Confirmed Chronic Obstructive Pulmonary Disease on Arterial Stiffness and Surfactant Protein D After Percutaneous Coronary Intervention. The CATEPOC Study

Autor: Komal Malik, Susana Diaz-Coto, Maria Jose de la Asunción Villaverde, Pablo Martinez-Camblor, Annie Navarro-Rolon, Francisco Pujalte, Alejandro De la Sierra, Pere Almagro
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: International Journal of Chronic Obstructive Pulmonary Disease.
ISSN: 1178-2005
Popis: Komal Malik,1 Susana Diaz-Coto,2 Maria de la Asunción Villaverde,1 Pablo Martinez-Camblor,3,4 Annie Navarro-Rolon,5,6 Francisco Pujalte,6 Alejandro De la Sierra,1 Pere Almagro1 1Internal Medicine Service, University Hospital Mútua de Terrassa, University of Barcelona, Barcelona, Spain; 2Epidemiology Department, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; 3Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; 4Faculty of Health Sciences, Universidad Autonoma de Chile, Providencia, 7500912, Chile; 5Pneumology Service, University Hospital Mútua de Terrassa, University of Barcelona, Barcelona, Spain; 6Immunology Department, Catlab Laboratory, Barcelona, SpainCorrespondence: Pere Almagro, Email 19908pam@comb.catBackground: Several mechanisms have been proposed to explain why chronic obstructive pulmonary disease (COPD) impairs the prognosis of coronary events. We aimed to explore COPD variables related to a worse prognosis in patients undergoing percutaneous coronary intervention (PCI).Methods: Patients with an acute coronary event treated by PCI were prospectively included. One month after discharge, clinical characteristics, comorbidities measured with the Charlson index, and prognostic coronary scales (logistic EuroSCORE; GRACE 2.0) were collected. Post-bronchodilator spirometry, arterial stiffness, and serum inflammatory and myocardial biomarkers were measured. Lung plasmatic biomarkers (Surfactant protein D, desmosine, and Clara cell secretory protein-16) were determined with ELISA. COPD was defined by the fixed ratio (FEV1/FVC < 70%). Spirometric values were also analyzed as continuous variables using adjusted and non-adjusted ANCOVA analysis. Finally, we evaluated the presence of a respiratory pattern defined by non-stratified spirometric values and pulmonary biomarkers.Results: A total of 164 patients with a mean age of 65 (± 10) years (79% males) were included. COPD was diagnosed in 56 (34%) patients (68% previously undiagnosed). COPD patients had a longer smoking history, higher scores on the EuroSCORE (p < 0.0001) and GRACE 2.0 (p < 0.001) scales, and more comorbidities (p = 0.006). Arterial stiffness determined by pulse wave velocity was increased in COPD patients (7.35 m/s vs 6.60 m/s; p = 0.006). Serum values of high sensitive T troponin (p = 0.007) and surfactant protein D (p = 0.003) were also higher in COPD patients. FEV1% remained significantly associated with arterial stiffness and surfactant protein D in the adjusted ANCOVA analysis. In the cluster exploration, 53% of the patients had a respiratory pattern.Conclusion: COPD affects one-third of patients with an acute coronary event and frequently remains undiagnosed. Several mechanisms, including arterial stiffness and SPD, were increased in COPD patients. Their relationship with the prognosis should be confirmed with longitudinal follow-up of the cohort.Keywords: acute coronary event, chronic obstructive pulmonary disease, ischaemic heart disease, percutaneous coronary intervention, arterial stiffness, surfactant protein D
Databáze: OpenAIRE
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