Peripheral artery disease (PAD) is a circulatory problem characterized by narrowed arteries, resulting in reduced blood flow to the limbs. Studies have shown that patients with PAD are at a higher risk of myocardial infarction (MI); however, the association is not well documented. This study aims to investigate the incidence and types of MI in patients with PAD.

This double-blind, randomized, clinical trial included a total of 13,885 patients with symptomatic PAD. Patients with the ankle-brachial index (ABI) of 0.80 or less were included. The patients were followed up at 30 months (median). The primary outcome of the study incident MI (spontaneous, secondary, sudden cardiac death, less than 48 hours of percutaneous coronary intervention, definite stent thrombosis, or less than  72 hours after CABG).

During the median follow-up of 30 months, MI occurred in 683 patients (4.9%). Risk factors associated with the risk of MI were age, diabetes, previous lower extremity revascularization, and a lower ABI. The most common type of MI was spontaneous, followed by secondary, less than 48 hours of percutaneous coronary intervention, and sudden cardiac death.

The research concluded that 5% of patients with PAD had an incident MI, with spontaneous MI being the most prevalent.