Highlights
- •Peripheral arterial disease is not significantly associated with 28-day case fatality after acute myocardial infarction.
- •Peripheral arterial disease is significantly associated with long-term mortality after acute myocardial infarction.
- •Patients with PAD younger than 63 years have the highest long-term mortality risk after AMI among all subgroups.
Abstract
Background
Little data is available on short- and long-term survival in patients with peripheral
arterial disease (PAD) after acute myocardial infarction (AMI). We aimed to examine
the association of PAD and 28-day case fatality as well as long-term mortality in
a population-based sample of patients with incident AMI.
Methods
In this secondary analysis of data from the German MONICA/KORA Myocardial Infarction
Registry 4307 patients aged 28–74 years with incident AMI with and without history of PAD (information derived from
medical chart) were included. Data were collected between 2000 and 2008. Patients
were followed-up until December 2011. Associations between PAD and 28-day case fatality
were examined via multivariable logistic regression models, between PAD and long-term
mortality with Cox proportional hazards regression models, respectively.
Results
From 303 (8.9%) patients with PAD, 22 (7.3%) died within 28-days post-AMI in contrast
to 96 (2.9%) of patients without PAD. However, the fully adjusted model (OR 1.55,
95% CI 0.89–2.70) revealed no significant association. Long-term follow-up (median
5.7 years) yielded 100 (32.4%) versus 483 (14.4%) cases of deaths among patients with
and without PAD, respectively. This association was significant (fully adjusted model:
HR 1.70, 95% CI 1.35–2.13), persisted up to 11 years after AMI and was present in all subgroups according to age, sex and history
of diabetes. The highest long-term mortality risk was found for patients younger than
63 years with PAD (HR 2.19; 95% CI 1.41–3.39).
Conclusion
AMI patients with PAD differ considerably from their counterparts without PAD in terms
of long-term survival.
Keywords
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Article info
Publication history
Published online: January 05, 2018
Accepted:
January 2,
2018
Received in revised form:
November 21,
2017
Received:
July 4,
2017
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
