Risk factors for myocardial infarction in patients with peripheral artery disease

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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.

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