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

Figures & data

Figure 1 Flowchart of participants, COPD prevalence, and underdiagnosis levels according to the fixed ratio (FEV1/FVC <0.7).

Table 1 Differences in Demographic and Clinical Characteristics of Patients with and without COPD

	Total	COPD	Non-COPD	P-value
	(n=164)	(n=56)	(n=108)
Age, years^a	65.0±10.2	69.0±8.3	62.9.0±10.6	<0.0001
Gender, male	130 (79%)	47 (84%)	83 (77%)	0.487
Body mass index^a	28.3±5.2	28.9.0±4.3	27.9±5.6	0.270
Non-adjusted Charlson index^b	1 [0–3]	2 [1–4]	1 [0–3]	0.006
Age-adjusted Charlson index^b	4 [2–6]	4 [3–7]	3 [2–5]	<0.001
Waist circumference^a	103.3±11.4	103.5±11.8	103.2±11.2	0.881
Smoking status
Never	45 (27.6%)	8 (14.3%)	37 (35.2%)	0.008
Former	86 (52.4%)	37 (66.0%)	49 (45.4%)	0.011
Current	32 (19.6%)	10 (17.9%)	22 (20.4%)	1.000
Package-years^b/c	30.0 [18.2–46.0]	40.0 [20.6–60.0]	30.0 [15.0–40.0]	0.015
Respiratory variables
FVC mL^a	3413.3±967.9	3181.9±972.0	3533.3±947.9	0.027
FVC %^a	85.4±16.9	81.6±18.7	87.4±15.7	0.040
FEV1 mL^a	2475.2±806.7	2020.0±737.1	2711.3±739.8	<0.0001
FEV1%^a	82.4±19.7	69.9±20.9	88.9±15.6	<0.0001
FEV1/FVC^b	72.50 [67.66–77.68]	65.59[59.32–67.78]	75.89[72.52–79.94]	<0.0001
Cardiovascular variables
Number of coronary stenosed arteries^b	2.0 [1.0–3.0]	1.5 [1.0–3.0]	2.0 [1.0–3.0]	0.131
Number of coronary lessons treated^b	1.0 [1.0–2.0]	1.0 [1.0–2.0]	1.0 [1.0–2.0]	0.867
Left ventricular ejection fraction^a	53.0±12.7	52.0±11.8	53.5±13.3	0.545
EuroSCORE^b	2.5 [1.5–5.1]	3.6 [2.1–6.2]	2.1 [1.3–4.3]	<0.0001
GRACE score^b	104.0 [85.0–119.0]	114.0[94.3–125.8]	97.0[78.0–116.0]	0.001
SYNTAX score^b	13.0 [7.0–21.0]	11.5 [7.0–19.9]	13.0 [7.0–23.5]	0.290

Notes: ^aValues expressed as mean and standard deviation. ^bValues expressed as median and interquartile range (IQR) 25–75%, and compared through Wilcoxon test. ^cPackage-years are computed just on ever smoker patients.

Table 2 Descriptive Statistics for Arterial Stiffness, Analytic Parameters, and Serum Biomarkers for the Total Cohort Stratified by COPD Diagnosis

	Total (n =164)	COPD (n=56)	Non-COPD (n=108)	P-value
Arterial stiffness
Arterial pulse wave velocity (m/s)^b	6.90 [6.00–8.17]	7.35 [6.40–8.70]	6.60 [5.73–7.88]	0.006
Central systolic pressure (mmHg)^a	119.83 ± 15.75	118.76 ± 16.46	120.38 ±15.42	0.534
Central pulse pressure^a	47.45 ± 13.27	47.29 ± 13.78	47.53 ± 13.07	0.912
Augmentation index^a	35.64 ± 12.61	34.29 ±12.09]	36.34 ±12.87	0.326
Cardio-ankle vascular index mean^b	9.40 [8.70–10.80]	9.70 [8.63–10.80]	9.01 [8.40–9.99]	0.023
Ankle-brachial pressure index mean^b	1.11 [0.98–1.19]	1.07 [0.92–1.16]	1.12 [0.99–1.20]	0.065
Analytic parameters
Hemoglobin (g/L)^a	13.99 ± 1.70	13.95 ± 2.00	14.01 ± 1.54	0.835
Leukocytes (10 ^9L)^a	7.98 ± 2.17	7.96 ± 1.90	7.99 ± 2.31	0.939
Creatinine (mg/dL)^a	1.03 ± 0.33	1.04 ± 0.33	1.03 ± 0.33	0.777
Glomerular filtration rate (mL/min)^a	59.52 ± 28.56	57.41 ± 27.26	60.61 ± 29.27	0.498
Albumin-creatinine ratio (mg/g)^a,c	1.20 ± 0.68	1.27± 0.67	1.16 ±0.7	0.245
Total cholesterol (mg/dl)^b	138.4 [118.3–162.8]	138.4 [118.3–167.0]	138.2 [118.0–161.4]	0.893
HDL cholesterol (mg/dl)^b	42.9 [36.0–52.6]	42.9 [35.6–53.7]	42.7 [36.1–52.1]	0.899
LDL cholesterol (mg/dl)^b	65.7 [49.5–81.2]	65.7 [48.7–85.1]	65.7 [49.9–81.1]	0.628
Serum inflammatory biomarkers
Fibrinogen (g/L)^a	4.47 ± 0.87	4.40 ± 0.89	4.51 ± 0.87	0.472
Hs-CRP(mg/L)^b	2.45 [0.93–6.06]	2.83 [1.17–7.97]	2.12 [0.79–5.85]	0.245
Myocardial biomarkers
NT-proBNP(pg/mL)^b	228 [93.75–744.15]	279.50 [134.50–816.50]	197.50 [70.00–699.00]	0.064
Hs-TNT(ng/mL)^b	11,97 [8.19–20.83]	14.19 [10.28–24.26]	10.97 [7.42–18.06]	0.007
Respiratory biomarkers	101	35	66
CC-16 (ng/mL)^b	8.59 [6.23–14.33]	8.59 [5.86–14.27]	8.57 [6.34–14.95]	0.808
Desmosine (ng/mL)^b	119.34 [81.24–189.72]	144.68 [92.09–203.28]	116.64 [79.37–185.46]	0.224
SPD (ng/mL)^b	18.24 [13.55–22.29]	19.64 [15.01–26.01]	14.71 [11.67–18.39]	0.003

Notes: ^aValues expressed as mean and standard deviation. ^bValues expressed as the median and interquartile range (IQR) 25–75%, and compared through Wilcoxon test. ^cLogarithmic transformation.

Table 3 Standardized Beta Coefficient for the Unadjusted and Adjusted (Age and Gender) Models. ANCOVA Analysis

	FEV1%				FEV1/FVC
	Unadjusted		Adjusted		Unadjusted		Adjusted
	Beta	P-value	Beta	P-value	Beta	P-value	Beta	P-value
cfPWV (m/s)	−0.27	<0.001	−0.24	0.003	−0.25	0.001	−0.16	0.037
CAVI	−0.12	0.142	−0.05	0.503	−0.16	0.04	−0.1	0.195
Hs-TNT (ng/mL)	−0.17	0.033	−0.10	0.237	−0.16	0.039	−0.07	0.374
NT-proBNP (pg/mL)	0.04	0.610	0.13	0.123	−0.06	0.430	0.08	0.330
Hs-CRP (mg/L)	−0.25	0.001	−0.23	0.003	−0.12	0.111	−0.06	0.465
SPD (ng/L)	−0.33	0.002	−0.30	0.004	−0.16	0.167	−0.1	0.402
LVEF	0.03	0.718	0.00	0.978	0.08	0.413	0.05	0.570
EUROSCORE	−0.13	0.091	−0.06	0.553	−0.22	0.004	−0.06	0.503
Charlson	−0.26	0.001	−0.21	0.008	−0.28	<0.001	−0.19	0.016
SYNTAX	0.05	0.563	0.09	0.271	0.08	0.285	0.17	0.026
GRACE	−0.16	0.044	−0.09	0.370	−0.28	<0.001	−0.12	0.213
Fibrinogen	−0.09	0.262	−0.09	0.300	−0.03	0.727	0.04	0.654

Abbreviations: cfPWV, arterial carotid-femoral pulse wave velocity; CAVI, Cardio-ankle vascular index; Hs-TNT, High sensitivity Troponin T; NT-proBNP, Brain natriuretic peptide; Hs-CRP, High sensitivity C reactive protein; SPD, Surfactant protein D; LEVF, Left ventricular ejection fraction; Charlson, Charlson index without age adjustment.

Table 4 Differences in Relevant Variables According to Cluster Group

	Group 1		Group 2		Group 3
	N=5		N=82		N=77
	Mean	SD	Mean	SD	Mean	SD	p-value
FEV1 (%)	66.60	25.02	71.89	17.22	94.62	14.14	0.0000
FVC (%)	80.60	22.14	77.23	14.60	94.42	14.37	0.0000
FEV1/FVC	59.83	12.45	69.43	9.86	74.97	6.31	0.0000
CC16	8.57	5.00	10.62	10.51	16.27	12.89	0.0070
SPD	20.00	7.69	22.24	15.33	16.14	7.67	0.0077
Packs-year	110.00	31.50	37.00	18.95	7.09	10.98	0.0000
Age	64.40	5.03	64.18	9.92	65.94	10.81	0.5567
Gender, male %	100%		85%		71%		0.0487
Charlson	2.00	1.00	2.15	1.90	1.55	1.54	0.0908
acfPWV	6.46	0.79	7.49	2.04	6.87	1.56	0.0673
CAVI	10.13	1.74	9.40	1.48	9.03	1.44	0.1146
LVEF	55.38	5.38	52.73	11.55	53.07	10.75	0.8691
EuroSCORE	3.03	2.14	4.10	5.77	4.94	5.51	0.5381
NT-pro BNP	130.00	60.15	588.09	850.40	626.43	938.11	0.4768
Hs-TNT	9.68	1.86	22.04	32.42	16.70	16.37	0.2989
Hs-CRP	1.65	1.46	8.00	11.33	3.24	6.05	0.0032
Fibrinogen	3.11	1.45	4.05	1.98	4.02	1.48	0.5064
GRACE 2.0	106.80	28.96	102.61	27.45	106.19	24.85	0.6783
SYNTAX	10.70	7.03	15.67	11.12	15.90	11.57	0.6057
ALB/CRE	12.57	16.42	88.87	236.42	41.04	101.91	0.2087

Figure 2 Dendrogram according to pulmonary related measures (FEV1%, FEV1/FVC, SPD and CC-16).

Figure 3 Forest plot with mean and 95% confidence interval comparison between selected variables stratified by clusters.