Polyvascular disease by systematic vascular screening and adverse outcomes in patients with acute myocardial infarction.

Polyvascular disease was identified in nearly one-third of AMI patients undergoing routine vascular screening.

• Among 233 eligible patients, PVD was identified in 73 patients (31.3%)
• 55 patients (23.6%) had single-territory PVD
• 18 patients (7.7%) had multiterritory PVD
• All patients underwent percutaneous coronary intervention for AMI at a single center

PVD burden showed a graded association with adverse cardiovascular event-free survival.

• During a median follow-up of 419 days, the primary endpoint occurred in 43 patients
• Kaplan-Meier analysis demonstrated a graded decrease in event-free survival according to increasing PVD burden
• Log-rank P = 0.014; P for trend = 0.007
• The primary endpoint was a composite of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and unplanned coronary revascularization after discharge

The association between PVD and adverse cardiovascular outcomes remained significant after multivariable adjustment.

• Cox proportional hazards analysis showed the presence of PVD was significantly associated with adverse cardiovascular outcomes
• The association remained significant after adjustment for age, sex, diabetes mellitus, and renal dysfunction
• Specific hazard ratios and confidence intervals were not reported in the abstract

Routine systematic vascular screening using ABI measurement and carotid ultrasonography was feasible during index AMI hospitalization.

• Ankle-brachial index (ABI) measurement and carotid ultrasonography were routinely performed during index hospitalization
• Peripheral artery disease was defined as ABI ≤ 0.90
• Carotid artery disease was defined as carotid plaque per the Mannheim consensus (maximal wall thickness ≥ 1.5 mm) or ≥50% carotid stenosis
• The study was a retrospective single-center observational study of consecutive patients