B Sigvant1,2, P Hasvold3, M Thuresson4, T Jernberg5, M Janzon6,7, J Nordanstig8. 1. Department of Surgical Science, Uppsala University Hospital, Sweden. 2. Department of Vascular Surgery, Central Hospital, Sweden. 3. AstraZeneca NordicBaltic, Sweden. 4. Statisticon AB, Sweden. 5. Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Sweden. 6. Department of Cardiology, Linköping University, Sweden. 7. Department of Medical and Health Sciences, Linköping University, Sweden. 8. Department of Molecular and Clinical Medicine at the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Sweden.
Abstract
BACKGROUND: Differences in comorbidity, pharmacotherapy, cardiovascular (CV) outcome, and mortality between myocardial infarction (MI) patients and peripheral arterial disease (PAD) patients are not well documented. AIM: The aim of this study was to compare comorbidity, treatment patterns, CV outcome, and mortality in MI and PAD patients, focusing on sex differences. METHODS: This observational, population-based study used data retrieved from mandatory Swedish national registries. The risks of MI and death were assessed by Kaplan-Meier analysis. Secondary preventive drug use was characterized. Cox proportional risk hazard modelling was used to determine the risk of specific events. RESULTS: Overall, 91,808 incident MI patients and 52,408 PAD patients were included. CV mortality for MI patients at 12, 24, and 36 months after index was 12.3%, 19.3%, and 25.4%, and for PAD patients it was 15.5%, 23.4%, and 31.0%. At index, 89% of MI patients and 65% of PAD patients used aspirin and 74% and 53%, respectively, used statins. Unlike MI women, women with PAD had a lower rate of other CV-related comorbidities and a lower risk of CV events (age-adjusted hazard ratio 0.81, 95% confidence interval 0.79‒0.84), CV death (0.78, 0.75‒0.82), and all-cause death (0.78, 0.76‒0.80) than their PAD male counterparts. CONCLUSION: PAD patients were less intensively treated and had a higher CV mortality than MI patients. Women with PAD were less likely than men to present with established polyvascular disease, whereas the opposite was true of women with MI. This result indicates that the lower-limb vasculature may more often be the index site for atherosclerosis in women. Published on behalf of the European Society of Cardiology. All rights reserved.
BACKGROUND: Differences in comorbidity, pharmacotherapy, cardiovascular (CV) outcome, and mortality between myocardial infarction (MI) patients and peripheral arterial disease (PAD) patients are not well documented. AIM: The aim of this study was to compare comorbidity, treatment patterns, CV outcome, and mortality in MI and PAD patients, focusing on sex differences. METHODS: This observational, population-based study used data retrieved from mandatory Swedish national registries. The risks of MI and death were assessed by Kaplan-Meier analysis. Secondary preventive drug use was characterized. Cox proportional risk hazard modelling was used to determine the risk of specific events. RESULTS: Overall, 91,808 incident MI patients and 52,408 PAD patients were included. CV mortality for MI patients at 12, 24, and 36 months after index was 12.3%, 19.3%, and 25.4%, and for PAD patients it was 15.5%, 23.4%, and 31.0%. At index, 89% of MI patients and 65% of PAD patients used aspirin and 74% and 53%, respectively, used statins. Unlike MI women, women with PAD had a lower rate of other CV-related comorbidities and a lower risk of CV events (age-adjusted hazard ratio 0.81, 95% confidence interval 0.79‒0.84), CV death (0.78, 0.75‒0.82), and all-cause death (0.78, 0.76‒0.80) than their PAD male counterparts. CONCLUSION: PAD patients were less intensively treated and had a higher CV mortality than MI patients. Women with PAD were less likely than men to present with established polyvascular disease, whereas the opposite was true of women with MI. This result indicates that the lower-limb vasculature may more often be the index site for atherosclerosis in women. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Fredrik Sartipy; Antonio José Garcia Pereira Filho; Fredrik Lundin; Eric Wahlberg; Birgitta Sigvant Journal: Int J Cardiol Cardiovasc Risk Prev Date: 2022-04-18
Authors: Christian-Alexander Behrendt; Birgitta Sigvant; Jenny Kuchenbecker; Matthew J Grima; Marc Schermerhorn; Ian A Thomson; Martin Altreuther; Carlo Setacci; Alexei Svetlikov; Elin H Laxdal; Frederico Bastos Goncalves; Eric A Secemsky; E Sebastian Debus; Kevin Cassar; Barry Beiles; Adam W Beck; Kevin Mani; Daniel Bertges Journal: Eur J Vasc Endovasc Surg Date: 2020-09-29 Impact factor: 7.069