Peripheral artery disease in patients with acute coronary syndrome without ST-segment elevation: impact on therapy and prognosis

• DOI: 10.1093/ehjacc/zuad036.063
• Publication Date: 2023-05-03T00:34:59Z
• Authors: M Carias; M Paralta; A Almeida; F Claudio; R Rocha; B Picarra; A Bento; M Trinca
• Keywords: Dyslipidemia; Stroke

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Peripheral artery disease (PAD) is an important co-morbidity in non-ST-segment elevation acute coronary syndromes (NSTEMI), and its presence may affect the therapeutic approach prognosis these patients. Purpose To assess impact PAD on approach, clinical outcome, in-hospital 1-year mortality patients with NSTEMI. Methods We studied 7248 NSTEMI included a national multicenter registry. considered 2 groups: without PAD. Demographic variables, CV risk factors, inpatient therapy, left ventricular function (LVF), angiography revascularization strategy performed were recorded. The following adverse events (AE) defined: death, re-infarction, stroke, heart failure (HF), cardiogenic shock (CC), major bleeding (MH), need for blood transfusion (BT). Length stay (IT) evaluated. Multivariate analysis was to whether predictor HAS and/or mortality. Results 7.3% (526 patients). These older (70±11 vs 67±13 years, p<0.001), higher prevalence males (82.1 70.7%, arterial hypertension (87.4 74.1%, diabetes mellitus ( 55.3 32.3%, dyslipidemia (76 61.9%, previous AMI (48.4 24.6%, PCI (28.4 17.5%, CABG 20.0 6.5%, stroke (25.4 7.5%, p<0.001) chronic renal (22.9 6.3%, p<0.001). Patients PAD: evolved more frequently Killip≥II (26.0 13.9%, LV dysfunction (LVF<50%: 42.7 28.3%, non-invasive ventilation (3 1.7%, p=0.019). less medicated beta-blockers (75 87.5%, diuretics (47.3 26.6%, underwent fewer angiograms (69.8 85.6%, p<0.002), but femoral used (35.2 21.4%) had multivessel (76.7 52.4%, longer duration (median 7 5 days, incidence re-AMI (3.1 1.4%, p=0.003), HF (26.7 12.4%, p=0.002), CC (3.2 1.8%, p=0.016), MH (2.3 1.1%, p=0.001) BT (4.6 1.6%, not stroke. In-hospital (4 2%, p=0.003) as well (16.2 6.2%, By multivariate analysis, independent (OR=1.57, 95% CI [1.04-2.58], p=0.032), AE. Conclusion affects therapy NSTEMI, being associated morbidity This constitutes death at 1 year.