Treatment practices and outcomes of patients with established peripheral arterial disease hospitalized with acute myocardial infarction in a community setting
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Authors
Spencer, Frederick A.Lessard, Darleen M.
Doubeni, Chyke A.
Yarzebski, Jorge L.
Gore, Joel M.
Goldberg, Robert J.
UMass Chan Affiliations
Department of Family Medicine and Community HealthDepartment of Medicine, Division of Cardiovascular Medicine
Document Type
Journal ArticlePublication Date
2007-01-19Keywords
Adrenergic beta-AntagonistsAged
Angiotensin-Converting Enzyme Inhibitors
Aspirin
Female
Hospitalization
Humans
Life Tables
Male
Massachusetts
Middle Aged
Myocardial Infarction
Peripheral Vascular Diseases
*Physician's Practice Patterns
Recurrence
Risk Factors
Smoking
Thrombolytic Therapy
Treatment Outcome
Biostatistics
Cardiovascular Diseases
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: There are little contemporary data available describing the hospital and long-term outcomes of patients with peripheral arterial disease (PAD) who are hospitalized with acute myocardial infarction (AMI). The objectives of our population-based study were to examine the hospital and long-term outcomes, as well as the use of different treatment practices, among patients with established PAD who were hospitalized with AMI. METHODS: The study sample consisted of 4480 patients hospitalized with AMI at all Worcester, Mass, medical centers in 4 alternate years between 1997 and 2003. RESULTS: Among the metropolitan Worcester residents hospitalized with AMI, 13.5% had a history of PAD. Prior use of proven cardiac therapies in patients with, and without, PAD was less than optimal though more often used in patients with prior PAD. Patients with PAD were significantly less likely to be treated with thrombolytic therapy during hospitalization than patients without PAD. Patients with PAD were not at significantly increased risk of dying during hospitalization (adjusted OR 1.29, 0.95% CI 0.97-1.71), though they were at a significantly increased risk of dying at 1 year after hospital discharge (adjusted OR 2.00, 95% CI 1.58-2.52) in comparison with patients without prior PAD. CONCLUSIONS: Approximately 1 in 8 patients presenting with AMI in this community-wide study had a history of clinically recognized PAD. These patients are at increased risk of dying during the first year after hospital discharge. Our data indicate that there is a room for improvement for the enhanced use of effective treatment modalities and implementation of secondary prevention strategies in these high-risk patients.Source
Am Heart J. 2007 Jan;153(1):140-6. Link to article on publisher's siteDOI
10.1016/j.ahj.2006.09.009Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47189PubMed ID
17174652Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.ahj.2006.09.009