Peripheral artery disease (PAD) severity was associated with higher in-hospital complications and readmissions among adults hospitalized with acute heart failure (HF), according to a nationally representative analysis published in Cardiology in Review. The study evaluated index admissions (≥18 years) with a primary diagnosis of acute HF and stratified patients by PAD severity using the Rutherford classification into non-PAD, PAD (categories 0–3), and critical limb ischemia (CLI; categories 4–6).

Relative to patients without PAD, those with PAD had higher adjusted odds of in-hospital mortality (adjusted odds ratio [aOR] 1.10; 95% confidence interval [CI] 1.03–1.18), acute kidney injury (AKI) (aOR 1.15; 95% CI 1.12-1.18), cardiogenic shock (aOR 1.13; 95% CI 1.03–1.23), nonhome discharge (aOR 1.15; 95% CI 1.11-1.18), and 30-day readmissions, including HF-related readmission (aOR up to 1.28). Hospital stay increased slightly (+0.39 days), along with a modest rise in costs (+$500).

Patients classified with CLI demonstrated markedly higher adjusted odds of adverse events, including mortality (aOR 2.77; 95% CI 2.06-3.73), cardiogenic shock (aOR 2.31; 95% CI 1.65-3.24), AKI (aOR 1.41; 95% CI 1.21-1.65), and dialysis-requiring AKI (aOR 4.55; 95% CI 2.19-9.47). These patients also had greater resource utilization, reflected by longer hospital stays (+5.07 days) and increased costs (+$19,700), along with higher 30-day readmission rates (aOR 1.59; 95% CI 1.33-1.90).

These findings indicate that increasing PAD severity is associated with worse in-hospital outcomes and higher resource utilization during acute HF admissions.