Cardiology
One-Year Cardiovascular Event Rates in a Global Contemporary Registry of Over 68,000 Outpatients with Atherothrombosis - REACH Registry Results
By American College of Cardiology
Mar 13, 2006, 20:37

Patients with atherothrombosis--a condition in which atherosclerosis is complicated by a propensity to form blood clots-- have a surprisingly high risk of death or major cardiovascular illness, even in stable form, according to data from a large international registry. Within a year, one in eight patients will die, will have a heart attack or stroke, or will be hospitalized for a complication of clogged arteries. The risk is even greater for patients with widespread vascular disease.

"I find these event rates to be high, given that we are dealing with a stable outpatient population treated with contemporary therapy," said Philippe Gabriel Steg, M.D., a professor of cardiology at Universit� Paris-7 and director of the coronary care unit at H�pital Bichat-Claude Bernard, Assistance Publique-H�pitaux de Paris, France.

This study was specifically designed to determine the "real-world" risk of a major adverse cardiovascular event (MACE) in patients with either established atherothrombotic disease or a high risk for the condition. Drawing from a wide geographic area--44 countries in all--Dr. Steg and his colleagues recruited 68,000 patients with a history of coronary artery disease (CAD), cerebrovascular disease (CVD), or peripheral vascular disease (PVD), or at least three risk factors for atherothrombosis, including diabetes, uncontrolled high blood pressure, uncontrolled high blood cholesterol levels, cigarette smoking and advanced age. Participants were enrolled in the Reduction of Atherothrombosis for Continued Health (REACH) registry and will be followed-up for four years.

At one-year follow-up, investigators observed an overall MACE rate of 13 percent. However, patients with peripheral arterial disease--clogged arteries in the legs or abdominal organs--were at substantially higher risk, experiencing a one-year MACE rate of 22 percent. In addition, there was a stepwise increase in risk in those with widespread vascular disease. In patients with atherothrombotic disease in one location only, the MACE rate was 13 percent, whereas in those with atherothrombotic disease in three locations, the MACE risk climbed to 28 percent.

"It is critical that we stop viewing atherothrombosis as a cardiac, neurologic, or vascular disease and, instead, view it as a global disease," Dr. Steg said.

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