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

Myocardial Infarction Incidence in Patients with PAD

JAMA Cardiol; ePub 2018 Dec 12; Olivier, et al

During a median follow-up of 30 months, approximately 5% of patients with symptomatic peripheral artery disease (PAD) had an myocardial infarction (MI), a recent study found. Researchers sought to characterize the incidence and types of MI in a PAD population, identify factors associated with MI, and determine the association of MI with cardiovascular (CV) mortality and acute limb ischemia. The EUCLID randomized clinical trial randomized 13,885 patients with symptomatic PAD to monotherapy with ticagrelor or clopidogrel. They found:

  • MI occurred in 683 patients (4.9%; 2.4 events per 100 patients-years) during a median follow-up of 30 months.
  • Type 1 MI (spontaneous) was the most common type of MI; one-third of MIs were type 2 MI (secondary).
  • MI was associated with an increased risk of CV death and acute limb ischemia events.


Olivier CB, Mulder H, Hiatt WR, et al. Incidence, characteristics, and outcomes of myocardial infarction in patients with peripheral artery disease. Insights from the EUCLID Trial. [Published online ahead of print December 12, 2018]. JAMA Cardiol. doi:10.1001/jamacardio.2018.4171.

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