Lisa Dinser1, Christa Meisinger2, Ute Amann3, Margit Heier4, Christian Thilo5, Bernhard Kuch6, Annette Peters7, Inge Kirchberger8. 1. Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Stenglinstraße 2, 86156 Augsburg, Germany; Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Ludwig-Maximilians-Universität München, Institute for Medical Information Processing, Biometrics and Epidemiology, Marchioninistraße 15, 81377 München, Germany. 2. Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Ludwig-Maximilians-Universität München, Chair of Epidemiology, UNIKA-T Augsburg, Neusässer Str. 47, 86156 Augsburg, Germany. 3. Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Stenglinstraße 2, 86156 Augsburg, Germany; Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Ludwig-Maximilians-Universität München, Chair of Epidemiology, UNIKA-T Augsburg, Neusässer Str. 47, 86156 Augsburg, Germany. 4. Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Stenglinstraße 2, 86156 Augsburg, Germany; Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany. 5. Central Hospital of Augsburg, Department of Internal Medicine I - Cardiology, Stenglinstraße 2, 86156 Augsburg, Germany. 6. Central Hospital of Augsburg, Department of Internal Medicine I - Cardiology, Stenglinstraße 2, 86156 Augsburg, Germany; Hospital of Nördlingen, Department of Internal Medicine/Cardiology, Stoffelsberg 4, 86720 Nördlingen, Germany. 7. Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany. 8. Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Stenglinstraße 2, 86156 Augsburg, Germany; Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Ludwig-Maximilians-Universität München, Chair of Epidemiology, UNIKA-T Augsburg, Neusässer Str. 47, 86156 Augsburg, Germany; Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERcv), Spain. Electronic address: I.Kirchberger@unika-t.de.
Abstract
BACKGROUND: Little data is available on short- and long-term survival in patients with peripheral arterial disease (PAD) after acute myocardial infarction (AMI). We aimed to examine the association of PAD and 28-day case fatality as well as long-term mortality in a population-based sample of patients with incident AMI. METHODS: In this secondary analysis of data from the German MONICA/KORA Myocardial Infarction Registry 4307 patients aged 28-74years with incident AMI with and without history of PAD (information derived from medical chart) were included. Data were collected between 2000 and 2008. Patients were followed-up until December 2011. Associations between PAD and 28-day case fatality were examined via multivariable logistic regression models, between PAD and long-term mortality with Cox proportional hazards regression models, respectively. RESULTS: From 303 (8.9%) patients with PAD, 22 (7.3%) died within 28-days post-AMI in contrast to 96 (2.9%) of patients without PAD. However, the fully adjusted model (OR 1.55, 95% CI 0.89-2.70) revealed no significant association. Long-term follow-up (median 5.7years) yielded 100 (32.4%) versus 483 (14.4%) cases of deaths among patients with and without PAD, respectively. This association was significant (fully adjusted model: HR 1.70, 95% CI 1.35-2.13), persisted up to 11years after AMI and was present in all subgroups according to age, sex and history of diabetes. The highest long-term mortality risk was found for patients younger than 63years with PAD (HR 2.19; 95% CI 1.41-3.39). CONCLUSION: AMI patients with PAD differ considerably from their counterparts without PAD in terms of long-term survival.
BACKGROUND: Little data is available on short- and long-term survival in patients with peripheral arterial disease (PAD) after acute myocardial infarction (AMI). We aimed to examine the association of PAD and 28-day case fatality as well as long-term mortality in a population-based sample of patients with incident AMI. METHODS: In this secondary analysis of data from the German MONICA/KORA Myocardial Infarction Registry 4307 patients aged 28-74years with incident AMI with and without history of PAD (information derived from medical chart) were included. Data were collected between 2000 and 2008. Patients were followed-up until December 2011. Associations between PAD and 28-day case fatality were examined via multivariable logistic regression models, between PAD and long-term mortality with Cox proportional hazards regression models, respectively. RESULTS: From 303 (8.9%) patients with PAD, 22 (7.3%) died within 28-days post-AMI in contrast to 96 (2.9%) of patients without PAD. However, the fully adjusted model (OR 1.55, 95% CI 0.89-2.70) revealed no significant association. Long-term follow-up (median 5.7years) yielded 100 (32.4%) versus 483 (14.4%) cases of deaths among patients with and without PAD, respectively. This association was significant (fully adjusted model: HR 1.70, 95% CI 1.35-2.13), persisted up to 11years after AMI and was present in all subgroups according to age, sex and history of diabetes. The highest long-term mortality risk was found for patients younger than 63years with PAD (HR 2.19; 95% CI 1.41-3.39). CONCLUSION: AMI patients with PAD differ considerably from their counterparts without PAD in terms of long-term survival.
Authors: Thilak P Weerarathna; Meththananda Herath; Gayani Liyanage; Miyuru K Weerarathna; Vidarsha Senadheera Journal: Int J Prev Med Date: 2019-06-07