Impact of pre-existing vascular disease on clinical outcomes in patients with non-ST-segment myocardial infarction: a nationwide cohort study

Abstract Aims Little is known about the outcomes and processes of care patients with non ST-segment myocardial infarction (NSTEMI) who present “polyvascular” disease. Methods We analysed 287,279 NSTEMI using Myocardial Infarction National Audit Project (MINAP) registry. Clinical characteristics were according to history affected vascular bed; coronary artery disease (CAD), cerebrovascular (CeVD) peripheral (PVD), comparison a historically disease-free control group; comprising 167,947 (59%). Further analyses compared cumulative number beds our control. Results After adjusting for demographics management, bed was associated increased likelihood MACE (CAD OR: 1.06, 95% CI: 1.01–1.12, P=0.02) (CeVD 1.19, 1.12–1.27, P<0.001) (PVD 1.22, 1.13–1.33, in-hospital mortality 1.24, 1.16–1.32, 1.33, 1.21–1.46, P<0.001). Patients no less likely be discharged on statins 88%, CeVD 86%, CAD 90% 78%), those moderate (EF 30–49%) or severe left ventricular systolic dysfunction (LVSD) (EF<30%) ACE inhibitors 82%, 77%, PVD 74%). polyvascular DAPT 78%, 80%, 87%). Conclusion Polyvascular had higher adjusted incidence MACE. receive inhibitors/ARBs, but more DAPT. Funding Acknowledgement Type funding sources: None.