TY - JOUR
T1 - Temporal trends in characteristics and outcomes after myocardial infarction in patients with and without peripheral artery disease - A Nationwide, register-based follow-up study
AU - Andersen, Patricia Jessen
AU - Attar, Rubina
AU - Jensen, Svend Eggert
AU - Eftekhari, Ashkan
AU - Polcwiartek, Christoffer
AU - Søndergaard, Marc Meller
AU - Pareek, Manan
AU - Torp-Pedersen, Christian
AU - Kragholm, Kristian
N1 - Copyright © 2024 Elsevier B.V. All rights reserved.
PY - 2024/4/15
Y1 - 2024/4/15
N2 - Aim: Patients with peripheral artery disease (PAD) represent a high-risk population with increased morbidity and mortality. We aimed to examine trends in myocardial infarction (MI), PAD and adverse clinical outcomes from years 2000 to 2019. Methods: This nationwide Danish-based registry study included all patients with MI from years 2000–2019. Patients with PAD were compared to patients without PAD. Temporal changes in PAD prevalence over time was examined using the Cochrane-Armitage trend test, and Cox regression was used to test for between-group significance in all care and outcome measures. Results: A total of 196,635 patients experienced an MI within the study time frame; the prevalence of PAD over time showed a slight increase (p < 0.01). Patients with MI and a concurrent PAD diagnosis elicited a heavier burden of comorbidities. The primary MACE endpoint showed significant decreases in both patients with and without PAD (p < 0.01); the decrease was more marked in patients without a concurrent PAD diagnosis (p < 0.01) alongside with 1-year all-cause mortality (p < 0.01). There was a slight increase in initiation of preventive pharmacotherapy with a prominent increase in initiation of P2Y12-inhibitors post discharge in patients without PAD in comparison to patients with PAD, and the same pattern applied for lipid lowering agents (p < 0.01). Also, there was an increase in revascularization in patients with MI but more markedly in patients without coexisting PAD. Conclusions: Despite significant decreases in MACE and mortality and significant increases in guideline-recommended care and revascularization over time for MI patients both with and without PAD, improvement in all these measures was less prominent in patients with MI and concomitant PAD.
AB - Aim: Patients with peripheral artery disease (PAD) represent a high-risk population with increased morbidity and mortality. We aimed to examine trends in myocardial infarction (MI), PAD and adverse clinical outcomes from years 2000 to 2019. Methods: This nationwide Danish-based registry study included all patients with MI from years 2000–2019. Patients with PAD were compared to patients without PAD. Temporal changes in PAD prevalence over time was examined using the Cochrane-Armitage trend test, and Cox regression was used to test for between-group significance in all care and outcome measures. Results: A total of 196,635 patients experienced an MI within the study time frame; the prevalence of PAD over time showed a slight increase (p < 0.01). Patients with MI and a concurrent PAD diagnosis elicited a heavier burden of comorbidities. The primary MACE endpoint showed significant decreases in both patients with and without PAD (p < 0.01); the decrease was more marked in patients without a concurrent PAD diagnosis (p < 0.01) alongside with 1-year all-cause mortality (p < 0.01). There was a slight increase in initiation of preventive pharmacotherapy with a prominent increase in initiation of P2Y12-inhibitors post discharge in patients without PAD in comparison to patients with PAD, and the same pattern applied for lipid lowering agents (p < 0.01). Also, there was an increase in revascularization in patients with MI but more markedly in patients without coexisting PAD. Conclusions: Despite significant decreases in MACE and mortality and significant increases in guideline-recommended care and revascularization over time for MI patients both with and without PAD, improvement in all these measures was less prominent in patients with MI and concomitant PAD.
KW - Major adverse cardiovascular events
KW - Myocardial infarction
KW - Peripheral artery disease
KW - Preventive pharmacotherapy
KW - Temporal trends
UR - http://www.scopus.com/inward/record.url?scp=85184781380&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2024.131812
DO - 10.1016/j.ijcard.2024.131812
M3 - Journal article
C2 - 38280530
SN - 0167-5273
VL - 401
JO - International Journal of Cardiology
JF - International Journal of Cardiology
M1 - 131812
ER -