Impact of polyvascular disease on baseline characteristics, management and mortality in acute myocardial infarction. The Alliance project

Meizels, Anouk; Zeitoun, David Messika; Bataille, Vincent; Cambou, Jean-Pierre; Collet, Jean‐Philippe; Cottin, Yves; Dujardin, Jean-Jacques; Goldstein, Patrick; Danchin, Nicolás; Thomas, Daniel; Steg, Philippe Gabriel

doi:10.1016/j.acvd.2010.02.002

Cited by 37 publications

(41 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[8][9][10][11][12] Interestingly, in this study the patients younger than 69 years showed the highest risk not only for 28-day case fatality, but also for an absence of chest pain and delayed hospital admission. It may be hypothesized that patients who have both AMI and Table 2.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 It has been shown that PAD is associated with increased cardiovascular morbidity and mortality and it is frequently linked with acute myocardial infarction (AMI). [3][4][5][6][7] The adverse effect of PAD on short-term survival in acute coronary syndrome, including AMI, has been confirmed in some studies, [8][9][10][11][12][13] but other trials have yielded conflicting results. 3,14 Although some evidence is available regarding the influence of PAD on outcomes after AMI, the relations between PAD and presenting AMI symptoms as well as the pre-hospital delay time (PHDT) are unclear.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Presenting symptoms, pre-hospital delay time and 28-day case fatality in patients with peripheral arterial disease and acute myocardial infarction from the MONICA/KORA Myocardial Infarction Registry

Kirchberger

Amann

Heier

et al. 2016

Eur J Prev Cardiolog

View full text Add to dashboard Cite

Background: Previous studies have indicated that patients with acute myocardial infarction (AMI) who have a history of peripheral arterial disease (PAD) have different characteristics and poorer outcomes than patients without PAD. However, data on short-term mortality are conflicting and it is unclear whether patients with PAD have a different scope of AMI symptoms or differences in pre-hospital delay time (PHDT) compared with patients without PAD. The objective of this study was to determine the associations between a history of PAD and presenting AMI symptoms, PHDT and 28-day case fatality in a population-based sample of patients with AMI. Design: This was an observational study. Methods: Information on history of PAD was obtained from the patients' medical records and their AMI symptoms were assessed by interviews with patients. Multivariable logistic regression models were used to determine the association of PAD with AMI symptoms and 28-day case fatality. A multivariable linear regression model was developed to examine the relations between PAD and PHDT. Results: From the 5848 patients with AMI included in this study, 9.8% had a history of PAD. Patients with PAD were significantly less likely to report chest symptoms (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.41-0.66) or pain in the upper left extremity (OR 0.67, 95% CI 0.54-0.84) than patients without PAD. PAD was significantly related with longer PHDT in patients <69 years of age (p ¼ 0.0117) and men (p ¼ 0.0104). A significantly higher 28-day case fatality (OR 2.09, 95% CI 1.47-2.96) was found in patients with PAD compared with patients without PAD. Conclusions: Patients with PAD should receive comprehensive education on the possibility of atypical AMI symptoms and the need to call emergency medical services immediately.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Presenting symptoms, pre-hospital delay time and 28-day case fatality in patients with peripheral arterial disease and acute myocardial infarction from the MONICA/KORA Myocardial Infarction Registry

Kirchberger

Amann

Heier

et al. 2016

Eur J Prev Cardiolog

View full text Add to dashboard Cite

show abstract

“…The in-hospital mortality rates of ap- The reported in-hospital mortality in the Worcester population was similar with 14.8 % for AMI with concomitant PAD [21], but the Alliance project showed a slightly lower in-hospital mortality of 9.8 % for AMI+PAD and 13 % for AMI + PAD + CVD [2]. PAMISCA showed a mortality of 13.4 % in ACS with clinical PAD and 7 % with subclinical PAD during follow-up (382 days); however this registry excluded patients that died within the "acute phase of ACS" [13].…”

Section: Discussionmentioning

confidence: 99%

“…However, compared to data from the Gusto IIb study (PAD ratio: 7.3 % in male and 6.2 % in female STEMI) [20], the French Alliance Project (PAD ratio of 8 % in AMI) [2], the GRACE registry (9.4 % PAD in ACS) [7], or data from the Worcester area (13.5 % PAD in AMI) [21], these PAD ratios appear relatively low. In the German MONICA/KORA registry, a PAD ratio of 10 % in female and 10.7 % in male AMI patients was reported, although patients aged ≥ 75 years were excluded from the registry [22].…”

Section: Discussionmentioning

confidence: 99%

Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting

Freisinger

Malyar

Reinecke

2016

Vasa

View full text Add to dashboard Cite

Summary:Background: Patients with peripheral arterial disease (PAD) are at high risk for cardiovascular morbidity and mortality. The objective of this nationwide analysis was to explore the association of PAD with in-hospital mortality in patients hospitalized for acute myocardial infarction (AMI). Patients and methods: Data on all in-patient hospitalizations in Germany are continuously transferred to the Federal Statistical Offi ce (DESTATIS), as required by federal law. These case-based data on AMI in the years 2005, 2007 and 2009 were analyzed regarding ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) as the primary diagnoses and concomitant PAD as the secondary diagnosis with respect to age and gender related disparity. Results: We analyzed 619,103 AMI cases, including 270,026 (43.6 %) with STEMI and 349,077 (56.4 %) with NSTEMI. The PAD ratio was 3.4 % in STEMI and 5.7 % in NSTEMI. In STEMI, in-hospital mortality was 15.6 % in cases with PAD vs. 12.0 % without, and 12.0 % vs. 9.8 % in NSTEMI, respectively (P < 0.001; 2009). Although female gender was associated with a signifi cantly higher in-hospital mortality, the presence of PAD particularly negatively affected in-hospital mortality in men (+ 60 % male vs -11 % female in STEMI; + 33 % male vs -3 % female in NSTEMI). Conclusions: Our data demonstrate the adverse impact of concomitant PAD on in-hospital mortality in AMI, in a large-scale, real-world scenario. Further research, particularly with a focus on gender, is needed to identify diagnostic and therapeutic measures to reduce the remarkably high in-hospital mortality of AMI patients with concomitant PAD.

show abstract

“…The Alliance study, (7) conducted on 9,783 patients who were hospitalised for AMI in France from 2000 to 2005, showed that PVA was an important predictor of prognosis. This result could be explained by not only the greater severity of the atherosclerotic process but also the prevalent diagnostic and treatment attitudes, which were more conservative for this subset of patients.…”

Section: Introductionmentioning

confidence: 99%

Coronary artery calcium score and coronary computed tomography angiography for patients with asymptomatic polyvascular (non-coronary) atherosclerosis

Cecere¹,

Riccioni²,

Sforza³

et al. 2017

smedj

View full text Add to dashboard Cite

Impact of polyvascular disease on baseline characteristics, management and mortality in acute myocardial infarction. The Alliance project

Cited by 37 publications

References 21 publications

Presenting symptoms, pre-hospital delay time and 28-day case fatality in patients with peripheral arterial disease and acute myocardial infarction from the MONICA/KORA Myocardial Infarction Registry

Presenting symptoms, pre-hospital delay time and 28-day case fatality in patients with peripheral arterial disease and acute myocardial infarction from the MONICA/KORA Myocardial Infarction Registry

Peripheral artery disease is associated with high in-hospital mortality particularly in males with acute myocardial infarction in a nationwide real-world setting

Coronary artery calcium score and coronary computed tomography angiography for patients with asymptomatic polyvascular (non-coronary) atherosclerosis

Contact Info

Product

Resources

About