Key result
PAD linked to ~2-fold higher long-term mortality risk after acute myocardial infarction.
Why the study?
Data are limited on long-term survival in women with peripheral arterial disease following acute myocardial infarction, as women often differ from men in age, treatment, and comorbidities.
Does peripheral arterial disease increase the risk of long-term all-cause mortality in patients with incident acute myocardial infarction?
Does peripheral arterial disease increase the risk of long-term all-cause mortality in patients with incident acute myocardial infarction?
Peripheral arterial disease is a significant independent predictor of long-term all-cause mortality in both men and women following an acute myocardial infarction.
PAD signals higher post-MI mortality risk in both sexes; extends observational data but leaves open whether interventions alter outcomes.
Background/Introduction There is limited data on the long-term survival of women with peripheral arterial disease (PAD) following acute myocardial infarction (AMI). Observational studies indicate that women with AMI tend to be older, receive less treatment, and have more comorbidities than men, making it challenging to assess the mortality risk associated with PAD alone. Purpose Our objective was to investigate the relationship between PAD and long-term mortality in a population-based cohort of patients with AMI. Methods In this secondary analysis of data from a single-center registry of patients with AMI, 2,429 patients were included. The median follow-up period was four years. Patients were stratified by sex, and Kaplan-Meier survival curves were generated and compared using the log-rank test. The association between PAD and long-term all-cause mortality was assessed using Cox proportional hazards regression models. Results Of the 2,429 patients, 675 (27.8%) were women, and 1,516 (62.4%) had ST-elevation myocardial infarction (STEMI). Among the 156 patients (6.4%) with PAD, 69 (44.2%) died during the study period. In contrast, long-term follow-up identified 388 deaths (17.1%) among patients without PAD. PAD was a significant predictor of mortality in the overall cohort, with an unadjusted hazard ratio (HR) of 3.04 (95% CI 2.35–3.93). After stratification by sex and adjustment for age, diabetes, smoking, estimated glomerular filtration rate (eGFR), and low-density lipoprotein (LDL), PAD remained significantly associated with mortality in both sexes, with an adjusted HR of 1.89 (95% CI 1.15–3.08) in women and 2.01 (95% CI 1.42–2.84) in men. Conclusion PAD appears to be a significant independent risk factor for long-term all-cause mortality in both women and men following AMI.All cause mortality in women
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Golubić et al. (2025) studied this question. Peripheral arterial disease independently increased long-term mortality risk after acute myocardial infarction, with adjusted HR 1.89 in women and 2.01 in men.
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