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Updated: Jun 12, 2025

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

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Inpatient Outcomes for Patients With Peripheral Artery Disease Hospitalized for Acute Myocardial Infarction.

Jason Gusdorf^1,2, Kamil F Faridi³, Tracy Y Wang⁴

¹Department of Internal Medicine Beth Israel Deaconess Medical Center Boston MA USA.

Journal of the American Heart Association

|June 11, 2025

Summary

Patients with peripheral artery disease (PAD) have worse in-hospital outcomes following acute myocardial infarction (AMI). PAD increases mortality and major bleeding risk, emphasizing the need for targeted risk mitigation strategies in this vulnerable patient group.

Keywords:

NSTEMI STEMI atherosclerosis percutaneous coronary intervention peripheral arterial disease revascularization

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Published on: April 25, 2014

Area of Science:

Cardiology
Vascular Medicine
Clinical Outcomes Research

Background:

Patients with both peripheral artery disease (PAD) and coronary artery disease face elevated cardiovascular risks.
While long-term risks are known, in-hospital outcomes for acute myocardial infarction (AMI) patients with PAD are less understood.

Purpose of the Study:

To characterize contemporary in-hospital outcomes for patients with AMI and PAD.
To identify specific risks and outcomes associated with PAD in the context of AMI.

Main Methods:

Analysis of 493,740 AMI hospitalizations from the NCDR Chest Pain-MI Registry (January 2019-March 2023).
Primary outcomes: in-hospital mortality and major bleeding.
Secondary outcomes: cardiac arrest, cardiogenic shock, heart failure, stroke, and new dialysis initiation.
Multivariable adjustment using the NCDR validated risk model.

Main Results:

PAD was present in 7.4% of AMI hospitalizations.
PAD significantly increased in-hospital mortality (8.23% vs. 4.87%; aOR, 1.25) and major bleeding (aOR, 1.23).
Elevated mortality in PAD patients was observed across age groups and AMI types, including revascularized patients.

Conclusions:

Peripheral artery disease is an independent predictor of significantly worse in-hospital outcomes in patients with acute myocardial infarction.
These findings underscore the critical need for enhanced risk mitigation strategies for high-risk patients with both PAD and AMI.