Prevalence and Impact of Acute Myocardial Infarction in Hospitalized Patients With Peripheral Artery Disease: Analysis of the National Inpatient Sample

Abstract

The coexistence of peripheral artery disease (PAD) and acute myocardial infarction (AMI) is clinically important yet not well reported in inpatient settings. We conducted a retrospective cross-sectional study using the 2018-2020 National Inpatient Sample (NIS). Adult hospitalizations with a primary diagnosis of PAD were stratified by the presence of a secondary AMI diagnosis; multivariable logistic regression was used for binary outcomes and linear regression for continuous outcomes, adjusting for demographics, comorbidities, and hospital characteristics. Among 597 195 PAD hospitalizations, 10 835 (1.8%) had coexisting AMI. Compared with PAD-only patients, AMI cases were older (70 vs 67 years), had higher comorbidity (Charlson Index 5.3 vs 3.5), and greater in-hospital mortality (15% vs 1.6%). After adjustment, AMI was associated with higher mortality (odds ratio [OR] 6.04), acute heart failure (OR 5.54), ischemic stroke (OR 2.31), acute kidney injury (OR 2.50), and limb amputation (OR 1.44), as well as longer length of stay (+4.3 days) and higher inflation-adjusted charges (+$83 821; all P < .001). Concurrent AMI in hospitalized PAD patients is linked with significantly worse clinical outcomes and higher healthcare utilization, highlighting the need for early detection and aggressive cardiovascular risk management in this high-risk population.