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Impact of peripheral arterial disease and cerebrovascular disease on outcomes in patients undergoing PCI

Pavan Gadhe1, Raman Sharma1, Serdar Farhan2

  • 1Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.

International Journal of Cardiology. Heart & Vasculature
|April 20, 2026
PubMed

Insights

Patients with peripheral arterial disease (PAD) or cerebrovascular disease (CeVD) face higher risks of major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI). Subgroup analysis revealed prior interventions or stroke with hemiparesis significantly elevate these risks.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Patients with peripheral arterial disease (PAD) and cerebrovascular disease (CeVD) often experience poorer outcomes following percutaneous coronary intervention (PCI) for coronary artery disease (CAD).
  • Understanding the impact of these comorbidities and their specific presentations is crucial for risk stratification and management.

Purpose of the Study:

  • To investigate the influence of PAD and CeVD, including their subtypes, on clinical outcomes in patients undergoing PCI.
  • To identify specific patient subgroups at higher risk for adverse events post-PCI.

Main Methods:

  • A retrospective cohort study analyzed 21,978 patients undergoing PCI between 2012 and 2022.
  • Patients were stratified based on the presence and subtypes of PAD and CeVD.
  • Outcomes including Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) and bleeding were assessed at 1-year.

Main Results:

  • Patients with PAD, CeVD, or both (polyvascular) had a significantly higher 1-year MACCE risk compared to the control group (CAD only).
  • The highest MACCE risk was observed in patients with PAD and prior intervention, and CeVD with cerebrovascular accident (CVA) and hemiparesis.
  • Bleeding events were more frequent in polyvascular and PAD patients, particularly those with prior intervention.

Conclusions:

  • PAD, CeVD, and polyvascular disease are associated with increased MACCE risk in patients undergoing PCI.
  • Prior interventions and CVA with hemiparesis are key drivers of this elevated MACCE risk.
  • PAD and polyvascular disease, especially with prior intervention, are linked to a higher risk of bleeding events.

Keywords:
Adverse outcomesBleedingCerebrovascular diseaseCoronary artery diseasePercutaneous coronary interventionPeripheral artery disease

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