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Peripheral artery disease and outcomes in patients with acute myocardial infarction

Rubina Attar1,2, Axel Wester1, Sasha Koul1

  • 1Cardiology and Clinical Sciences, Lunds Universitet, Lund, Sweden.

Open Heart
|June 28, 2019
PubMed

Insights

Patients with peripheral artery disease (PAD) experiencing myocardial infarction (MI) face higher risks of major adverse cardiac events. This study highlights the need for better PAD diagnosis to improve outcomes in high-risk MI patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Public Health

Background:

  • Peripheral artery disease (PAD) signifies a high-risk population with adverse cardiac outcomes post-myocardial infarction (MI).
  • Real-world data on the clinical characteristics and event rates in MI patients with PAD are limited.

Purpose of the Study:

  • To characterize patients with PAD diagnosed concurrently with MI.
  • To investigate the incidence of major adverse cardiac events (MACE) within one year following MI in patients with and without PAD.

Main Methods:

  • Observational study utilizing nationwide Swedish registries (2005-2014).
  • Included MI patients with (n=4213) and without (n=106,763) concurrent PAD diagnosis.
  • Cox proportional hazard models were used for outcome comparison.

Main Results:

  • MI patients with PAD were older and had more comorbidities (diabetes, hypertension, prior MI).
  • Adjusted analyses revealed PAD significantly associated with increased 1-year MACE (HR 1.35), mortality (HR 1.59), reinfarction (HR 1.48), stroke (HR 1.27), heart failure (HR 1.29), and bleeding (HR 1.26).

Conclusions:

  • Concurrent PAD diagnosis is an independent predictor of adverse outcomes post-MI.
  • The observed low PAD prevalence suggests underdiagnosis, necessitating further investigation.
  • Screening for PAD using ankle-brachial index may improve diagnosis and management of polyvascular disease.
Abstract

Keywords:
epidemiologymyocardial infarctionperipheral artery disease

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