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Prognostic impact of peripheral artery disease-related parameters in patients with acute coronary syndrome

Gabriele Masini1, Luna Gargani, Carmela Morizzo

  • 1Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Pisa University Hospital, and Chair of Cardiology, University of Pisa, Pisa, Italy.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|August 5, 2024
PubMed

Insights

Lower extremity arterial disease (LEAD), even when subclinical, independently predicts mortality after acute coronary syndrome (ACS). Increased aortic stiffness, however, did not show a significant association with mortality in these patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Clinical Outcomes Research

Background:

  • Lower extremity arterial disease (LEAD) and aortic stiffness are linked to mortality in chronic coronary syndrome.
  • Their prognostic value after acute coronary syndrome (ACS) remains less understood.

Purpose of the Study:

  • To investigate the prevalence and clinical impact of LEAD and aortic stiffness in ACS patients.
  • To determine their association with all-cause mortality and major adverse cardiovascular events (MACE).

Main Methods:

  • Analysis of 270 ACS patients, assessing LEAD via ankle-brachial index (ABI) and aortic stiffness via pulse wave velocity (PWV).
  • Evaluation of associations with all-cause mortality and MACE, adjusting for confounders.

Main Results:

  • 15% of patients had LEAD (ABI ≤0.9), with 34% of those symptomatic.
  • LEAD patients exhibited more cardiovascular risk factors, poorer kidney function, and higher hs-CRP.
  • LEAD, symptomatic or not, was significantly associated with all-cause mortality (HR 4.03, P <0.01); PWV was not.
  • Neither LEAD nor PWV were associated with MACE.

Conclusions:

  • Subclinical or clinical LEAD is an independent predictor of all-cause mortality post-ACS.
  • Increased aortic stiffness is not an independent predictor of mortality in this patient cohort.
Abstract

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