Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Ischemic Events in Patients with PAD After an ACS

Am Heart J; ePub 2018 Mar 28; Inohara, et al

Following an acute coronary syndrome (ACS), patients with peripheral artery disease (PAD) have a significantly higher risk of first and recurrent ischemic events compared to those without PAD, a recent study found. Researchers analyzed the combined dataset from 4 randomized trials in ACS for a follow-up length of 1 year and examined the association between PAD and major adverse cardiovascular events (MACE), a composite of CV death, myocardial infarction (MI), and stroke. They found:

  • A total of 4,098 of 48,094 (8.5%) post-ACS patients had a history of PAD.
  • The unadjusted frequency of MACE was 2-fold higher in patients with PAD over a median follow-up of 353 days with an adjusted hazard ratio of 1.63.
  • The frequency of recurrent ischemic events among patients with a first, non-fatal event was higher among those with PAD.
  • Relative frequency of each event type within first and subsequent ischemic events was similar regardless of PAD status at baseline.


Inohara T, Pieper K, Wojdyla DM, et al. Incidence, timing, and type of first and recurrent ischemic events in patients with and without peripheral artery disease after an acute coronary syndrome. [Published online ahead of print March 28, 2018]. Am Heart J. doi:10.1016/j.ahj.2018.03.013.

This Week's Must Reads

Trends in LDL-C and 2013 Treatment Guidelines, Clin Cardiol; ePub 2018 Nov 15; Superko, et al

PCSK9 Inhibitors Reduce Risk of CV Events, Nat Rev Cardiol; ePub 2018 Nov 12; Sabatine, et al

Risk Factors for CVD in Heterozygous FH, J Clin Lipidol; ePub 2018 Nov 7; Akioyamen, et al

Hypercholesterolemia Patients on Suboptimal Statins, J Atheroscler Thromb; ePub 2018 Oct 26; Kajinami, et al

Cholesterol Guidelines Stress Lifetime Approach, Circulation; ePub 2018 Nov 10; Grundy, et al

Must Reads in Acute Coronary Syndromes

Treatment Gap in Primary Prevention Patients with ACS, Am J Cardiol; ePub 2018 Nov 7; Bavishi, et al

BP Goals & CV Outcomes in Patients with T2D, J Am Heart Assoc; ePub 2018 Oct 14; White, et al

PCI Trends Among Elderly Patients with ACS, Am J Cardiol; ePub 2018 Sep 27; Elbadawi, et al

Barriers to Healthcare Access After an ACS, Am J Cardiol; ePub 2018 Jul 15; Erskine, et al

LOS After Non-ST-Segment Elevation Acute MI, Am Heart J; ePub 2018 Apr 19; Rymer, et al