Risk factors for myocardial infarction in patients with peripheral artery disease

Background

Peripheral artery disease (PAD) is a worldwide major health problem characterized by a reduced blood flow in the arteries of the lower limbs due to obstructive atherosclerosis. PAD is afflicted by a high risk for adverse events of the limbs, but also by cardiovascular events such as myocardial infarction (MI).

Methods

The German nationwide inpatient statistics was used for this study. All patient-cases of patients admitted due PAD in Germany 2005–2020 were included and stratified for occurrence of MI.

Results

Overall, 2,825,765 patient-cases of patients admitted due to PAD were included in our study 2005–2020. Among these, 24,072 PAD patients (0.9 %) were afflicted by MI. PAD patients with MI were older (proportion of patients aged ≥70 years: 69.6 % vs. 54.2 %, P < 0.001) and revealed an aggravated comorbidity profile. In-hospital case-fatality rate was more than 10-fold increased driven by MI (29.0 % vs. 2.7 %, P < 0.001).

Age ≥ 70 years (OR 1.193 [95 %CI 1.158–1.229], P < 0.001), diabetes mellitus (OR 1.405 [95 %CI 1.369–1.442], P < 0.001), hyperlipidaemia (OR 1.099 [95 %CI 1.069–1.129], P < 0.001), COPD (OR 1.105 [95 %CI 1.064–1.148], P < 0.001), kidney disease (OR 1.857 [95 %CI 1.806–1.910], P < 0.001), heart failure (OR 4.907 [95 %CI 4.769–5.048], P < 0.001), atrial fibrillation/flutter (OR 1.177 [95 %CI 1.142–1.213], P < 0.001), cancer (OR 1.343 [95 %CI 1.242–1.451], P < 0.001) and pneumonia (OR 5.214 [95 %CI 5.021–5.414], P < 0.001) were independently associated with MI.

Conclusions

MI occurred in 0.9 % of the PAD patients and was afflicted by more than 10-fold increased case-fatality. Independent risk factors for MI events in patients admitted due to PAD comprised age ≥ 70 years, diabetes mellitus, hyperlipidaemia, lung diseases, and cancer.