Peripheral artery disease as a predictor of poor in-hospital outcomes in patients with acute myocardial infarction

Background: Research has demonstrated that individuals with acute myocardial infarction (AMI) and peripheral artery disease (PAD) experience more complications compared to those with AMI only. This study examines the impact of PAD on in-hospital outcomes in patients admitted with AMI. Methods: A retrospective cohort analysis of the National Inpatient Sample (NIS) was performed from January 2018 to December 2021. Adults (≥18 years) with a primary diagnosis of AMI were identified and stratified by the presence or absence of PAD as a comorbidity. Matching was done for patient demographics, comorbidities, and clinical characteristics. Multivariate logistic regression was employed to adjust for confounders. Results: After matching, each cohort included 96,955 patients. Compared to patients without PAD, those with PAD experienced significantly worse in-hospital outcomes. Patients with PAD had higher rates of all-cause in-hospital mortality (OR = 1.34, [1.29–1.41], p < 0.001), acute kidney injury (AKI) (OR = 1.08, [1.06–1.10], p < 0.001), and cerebrovascular accidents (CVAs) (OR = 1.28, [1.19–1.38], p < 0.001). There were no statistically significant differences in the incidence of access site hemorrhage (OR = 1.19, [0.88–1.60], p = 0.25) or retroperitoneal hemorrhage (OR = 0.84, [0.70–1.02], p = 0.08). Length of stay was not significant between groups (β = 0.007 days, [−0.10 to 0.11], p = 0.89). Conclusions: AMI with PAD patients was associated with increased in-hospital mortality, higher complication rates, and worse outcomes. These findings emphasize the need for focused efforts to improve outcomes in this high-risk patient subgroup.