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Atherosclerotic Coronary Plaque Features in Patients With Chronic Obstructive Pulmonary Disease and Acute Coronary Syndrome.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2024 Aug 01; Vol. 224, pp. 36-45. Date of Electronic Publication: 2024 Jun 12. - Publication Year :
- 2024
-
Abstract
- Previous studies reported a robust relation between chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD). Systemic inflammation has been proposed as possible pathogenetic mechanism linking these 2 entities, although data on atherosclerotic coronary features in COPD patients are lacking. We studied atherosclerotic coronary plaque features in COPD patients presenting with acute coronary syndrome (ACS) using optical coherence tomography (OCT). ACS patients who underwent intracoronary OCT imaging of the culprit vessel were enrolled. Coronary plaque characteristics and OCT-defined macrophage infiltration (MØI) were assessed by OCT. ACS patients were divided into 2 groups according to the presence of an established diagnosis of COPD, and plaque features at the culprit site and along the culprit vessel were compared between the groups. Of 146 ACS patients (mean age:66.1 ± 12.7 years, 109 men), 47 (32.2%) had COPD. Patients with COPD had significantly higher prevalence of MØI (78.7% vs 54.5%, p = 0.005) and thin cap fibroatheroma (TCFA) (48.9% vs 22.2%, p = 0.001) at the culprit site. In the multivariate logistic regression, COPD was independently associated with MØI (odds ratio [OR] 21.209, 95% confidence interval [CI] 1.679 to 267.910, p = 0.018) and TCFA at the culprit site (OR 5.345, 95% CI 1.386 to 20.616, p = 0.015). Similarly, COPD was independently associated with both MØI (OR 3.570, 95% CI 1.472 to 8.658, p = 0.005) and TCFA (OR 4.088, 95% CI 1.584 to 10.554, p = 0.004) along the culprit vessel. In conclusion, in ACS patients who underwent OCT imaging of the culprit vessel, COPD was an independent predictor of plaque inflammation and vulnerability. These results may suggest that a higher inflammatory milieu in COPD patients might enhance local coronary inflammation, promoting CAD development and plaque vulnerability.<br />Competing Interests: Declaration of competing interest The authors have no competing interests to declare. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.<br /> (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Male
Female
Aged
Middle Aged
Coronary Vessels diagnostic imaging
Coronary Vessels pathology
Coronary Angiography
Retrospective Studies
Risk Factors
Pulmonary Disease, Chronic Obstructive complications
Pulmonary Disease, Chronic Obstructive epidemiology
Plaque, Atherosclerotic diagnostic imaging
Plaque, Atherosclerotic complications
Acute Coronary Syndrome epidemiology
Tomography, Optical Coherence methods
Coronary Artery Disease epidemiology
Coronary Artery Disease complications
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 224
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 38871157
- Full Text :
- https://doi.org/10.1016/j.amjcard.2024.06.005