title: [Clinical and therapeutic specificities of myocardial infarction in patients with peripheral arterial disease: the USIC 2000 registry].
abstract: OBJECTIVE
  Several studies underlined the worse prognosis of myocardial infarction (MI) among patients with peripheral arterial disease (PAD). We sought to describe the presentation and management modalities of a cohort of PAD patients presenting an acute MI, compared to those without PAD.
  
  
  METHODS
  The USIC 2000 registry, a nationwide database on all patients admitted to a CCU for an acute MI < 48 hours in France in November 2000 was used for this study.
  
  
  RESULTS
  Among the 2311 patients included, PAD was reported in 215 subjects (9.3%). In multivariate analysis, the following factors were positively related to the presence of PAD (P < or = 0.05): age >75 y (OR = 2.3), diabetes (OR = 2.0), hypertension (OR = 1.4), active smoking (OR = 4.6), renal failure (OR =3.1), and treatments with antiplatelets (OR = 3.9), anti-vitamin K (OR = 1.9), statins (OR = 1.7) and low molecular weight heparins (OR = 6.8). By introducing the data concerning the arrival in CCUs in the model, the following factors were also significantly more frequent among PAD patients: male sex (OR = 1.6), past history of coronary artery disease (OR = 2.2), left bundle branch block (OR = 1.8) and late management >6 hours (OR = 1.4). Conversely, ST-segment elevation was less frequent (OR = 0.7). When the CCU stay data were introduced in the model, a lower rate of coronary stenting (OR = 0.7) and betablockers use within 48 hours of admission (OR = 0.6) were noted.
  
  
  CONCLUSIONS
  Beyond the presence of PAD per se, several particularities do exist, especially the coexistence of a high number of pejorative factors and an under-utilization of treatments presenting prognostic benefits.
authors.affiliation: U558 Inserm, 31, allée Jules-Guesde, 31037 Toulouse cedex, France. aboyans@unilim.fr
authors.forename: V
authors.initials: V
authors.lastname: Aboyans
authors.forename: J P
authors.initials: JP
authors.lastname: Cambou
authors.forename: G
authors.initials: G
authors.lastname: Hanania
authors.forename: C
authors.initials: C
authors.lastname: Cantet
authors.forename: J
authors.initials: J
authors.lastname: Ferrières
authors.forename: P
authors.initials: P
authors.lastname: Guéret
authors.forename: D
authors.initials: D
authors.lastname: Blanchard
authors.forename: J M
authors.initials: JM
authors.lastname: Lablanche
authors.forename: P
authors.initials: P
authors.lastname: Lacroix
authors.forename: Y
authors.initials: Y
authors.lastname: Boutalbi
authors.forename: N
authors.initials: N
authors.lastname: Danchin
mesh_terms: D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy*; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000628:therapy; D011446:Prospective Studies; D012042:Registries