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    Treatment practices and outcomes of patients with established peripheral arterial disease hospitalized with acute myocardial infarction in a community setting

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    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 Health
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2007-01-19
    Keywords
    Adrenergic beta-Antagonists
    Aged
    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
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    Link to Full Text
    http://dx.doi.org/10.1016/j.ahj.2006.09.009
    Abstract
    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 site
    DOI
    10.1016/j.ahj.2006.09.009
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47189
    PubMed ID
    17174652
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ahj.2006.09.009
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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