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.

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