Clinical Characteristics and Adverse Events in Acute Coronary Syndrome Patients with a History of Peripheral Arterial Disease

Abstract Background: In clinical observation, patients with acute coronary syndrome complicated with peripheral artery disease have poor prognosis, so the relationship between the diseases and clinical characteristics need to be further explored. Objective: This study aims to investigate clinical characteristics and independent risk factors for in-hospital adverse events in acute coronary syndrome patients with a history of peripheral arterial disease (PAD). Methods: A total of 5,682 patients with acute coronary syndrome were included into this study. These patients were divided into two groups according to the presence or absence of a history of PAD: PAD group (n = 188), and non-PAD (control) group (n = 5,494). Then, the clinical characteristics and incidence of in-hospital adverse events were analyzed; p < 0.05 was considered statistically significant. Results: The age of PAD patients was higher than that in the control group (65.5 ± 10.3 years vs. 58.6 ± 11 years, p < 0.001), and the proportion of PAD patients with diabetes history and stroke history was higher than that in the control group (73 [39%] vs. 1472 [26.8%], p = 0.018; 36 [19.3%] vs. 396 [7.2%], p < 0.001). The multivariate logistic regression analysis between groups based on in-hospital adverse events revealed that a history of PAD (OR = 1.791, p = 0.01), a history of diabetes (OR = 1.223, p = 0.001), and age of > 65 years old (OR = 4.670, p < 0.001) were independent risk factors for in-hospital adverse events. Conclusion: A history of PAD, advanced age, and a history of diabetes are independent risk factors for in-hospital adverse events in patients with acute coronary syndrome.

研究背景：临床观察显示，合并外周动脉疾病（peripheral arterial disease, PAD）的急性冠状动脉综合征（acute coronary syndrome, ACS）患者预后不佳，目前该两类疾病的关联及其临床特征仍有待进一步探究。研究目的：本研究旨在探讨伴有外周动脉疾病病史的急性冠状动脉综合征患者的临床特征，以及其院内不良事件的独立危险因素。研究方法：本研究共纳入5682例急性冠状动脉综合征患者，根据是否存在外周动脉疾病病史分为两组：PAD组（n=188）与非PAD对照组（n=5494）。随后对两组患者的临床特征及院内不良事件发生率进行分析，以P<0.05作为差异具有统计学意义的判定标准。研究结果：PAD组患者平均年龄高于对照组（65.5±10.3岁 vs 58.6±11.0岁，P<0.001）；且PAD组患者合并糖尿病病史、脑卒中病史的比例均显著高于对照组（糖尿病病史：73例[39.0%] vs 1472例[26.8%]，P=0.018；脑卒中病史：36例[19.3%] vs 396例[7.2%]，P<0.001）。基于院内不良事件的组间多因素logistic回归分析结果显示，外周动脉疾病病史（OR=1.791，P=0.01）、糖尿病病史（OR=1.223，P=0.001）以及年龄＞65岁（OR=4.670，P<0.001）为急性冠状动脉综合征患者院内不良事件的独立危险因素。研究结论：外周动脉疾病病史、高龄以及糖尿病病史是急性冠状动脉综合征患者发生院内不良事件的独立危险因素。