Impact of COPD on the Follow-up of Patients with Acute Coronary Syndrome.

Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease and typically experience worse mid- and long-term outcomes after myocardial infarction compared to those without COPD. Our recent findings revealed a COPD prevalence of 15.5% among patients diagnosed with acute coronary syndrome (ACS). Following a mean follow-up period of 2.9 years, no statistically significant disparities in mortality rates were observed between patients with and without COPD. We analyzed data from the 258 ACS patients included in our original study, all of whom underwent post-bronchodilator spirometry within 30 to 60 days after hospital discharge following ACS. The primary outcome consisted of a composite endpoint encompassing major adverse cardiovascular events (MACE), comprising hospitalization for new ACS, revascularization procedures, stroke or transient ischemic attack, exacerbation of heart failure, and mortality. We conducted multivariable Cox regression analysis with backward elimination to identify predictors of MACE, including age, sex, BMI, tobacco use, comorbidities, and COPD status (yes vs. no). Age, BMI, and COPD status remained independent predictors in the multivariable adjusted models, with hazard ratios (HRs) of 1.06 (95% CI 1.04 to 1.09), 1.06 (95% CI 1.01 to 1.12), and 0.20 (95% CI 0.05 to 0.83), respectively. Further adjustments in the final model for history of cardiovascular disease or type of ACS, did not alter the observed low risk associated with the COPD group. In conclusion, our study emphasizes that age and excess weight are key risk factors for MACE in ACS patients over a three-year follow-up, regardless of COPD status.