Prevalence and Prognostic Influence of Peripheral Arterial Disease in Patients ≥40 Years Old Admitted into Hospital Following an Acute Coronary Event

Abstract

Objective A significant proportion of patients with ischemic heart disease have associated peripheral arterial disease (PAD), but many are asymptomatic and this condition remains underdiagnosed. We aimed to study the prevalence of PAD in patients with an acute coronary syndrome (ACS) and to evaluate its influence in hospital clinical outcomes. Methods The PAMISCA register is a prospective, multicenter study involving patients ≥40 years old with ACS admitted to selected Spanish hospitals. All patients had their ankle-brachial index (ABI) measured between days 3 and 7 after the ischemic event. Results 1410 ACS patients (71.4% male) were included. PAD determined by ABI was documented in 561 patients (39.8%). Factors independently related to PAD were age (OR: 1.04; 95% CI: 1.03–1.06; p < 0.001), smoking (OR: 1.88; 95% CI: 1.41–2.49; p < 0.0001), diabetes (OR: 1.30; 95% CI: 1.02–1.65; p < 0.05), previous cardiac disease (OR: 1.54; 95% CI: 1.22–1.95; p < 0.001) and previous cerebrovascular disease (OR: 1.90; 95% CI: 1.28–2.80; p < 0.001). Following the ACS, an ABI ≤ 0.90 was associated with increased cardiovascular mortality (OR: 5.45; 95% CI: 1.16–25.59; p < 0.05) and a higher risk of cardiovascular complications. Conclusion The prevalence of PAD in patients ≥40 years presenting with ACS is high and it is associated with increased cardiovascular risk.