1. Three-year follow-up and event rates in the international REduction of Atherothrombosis for Continued Health Registry
- Author
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Mark J, Alberts, Deepak L, Bhatt, Jean-Louis, Mas, E Magnus, Ohman, Alan T, Hirsch, Joachim, Röther, Geneviève, Salette, Shinya, Goto, Sidney C, Smith, Chiau-Suong, Liau, Peter W F, Wilson, and Ph Gabriel, Steg
- Subjects
Male ,Cardiac & Cardiovascular Systems ,Myocardial Infarction ,Atherothrombosis ,Disease ,ESC clinical trial updates ,Coronary artery disease ,REduction of Atherothrombosis for Continued Health Registry Investigators ,Esc Barcelona Fasttrack ,Recurrence ,Ambulatory Care ,Secondary Prevention ,Registries ,Myocardial infarction ,Cerebrovascular disease ,Stroke ,Peripheral Vascular Diseases ,Smoking ,Hospitalization ,Treatment Outcome ,Hypertension ,Cardiology ,LIFE-STYLE ,Female ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,ACUTE MYOCARDIAL-INFARCTION ,medicine.medical_specialty ,1102 Cardiovascular Medicine And Haematology ,Medication Adherence ,Diabetes Complications ,Central nervous system disease ,Internal medicine ,Peripheral arterial disease ,medicine ,ATTACK ,Hypoglycemic Agents ,Humans ,Obesity ,Risk factor ,Antihypertensive Agents ,Aged ,Science & Technology ,Vascular disease ,business.industry ,Anticoagulants ,Cardiovascular Agents ,GLOBAL BURDEN ,medicine.disease ,Atherosclerosis ,PREVENTION ,Surgery ,Cardiovascular System & Hematology ,Risk factors ,Cardiovascular System & Cardiology ,RISK-FACTORS ,CARDIOVASCULAR-DISEASES ,GENDER ,business ,COSTS ,Fibrinolytic agent ,Follow-Up Studies - Abstract
Aims To determine 3-year event rates in outpatients with vascular disease enrolled in the REduction of Atherothrombosis for Continued Health (REACH) Registry. Methods and results REACH enrolled 67 888 outpatients with atherothrombosis [established coronary artery disease (CAD), cerebrovascular disease, or peripheral arterial disease (PAD)], or with at least three atherothrombotic risk factors, from 44 countries. Among the 55 499 patients at baseline with symptomatic disease, 39 675 were eligible for 3-year follow-up, and 32 247 had data available (81% retention rate). Among the symptomatic patients at 3 years, 92% were taking an antithrombotic agent, 91% an antihypertensive, and 76% were on lipid-lowering therapy. For myocardial infarction (MI)/stroke/vascular death, 1- and 3-year event rates for all patients were 4.2 and 11.0%, respectively. Event rates (MI/stroke/vascular death) were significantly higher for patients with symptomatic disease vs. those with risk factors only at 1 year (4.7 vs. 2.3%, P < 0.001) and at 3 years (12.0 vs. 6.0%, P < 0.001). One and 3-year rates of MI/stroke/vascular death/rehospitalization were 14.4 and 28.4%, respectively, for patients with symptomatic disease. Rehospitalization for a vascular event other than MI/stroke/vascular death was common at 3 years (19.0% overall; 33.6% for PAD; 23.0% for CAD). For patients with symptomatic vascular disease in one vascular bed vs. multiple vascular beds, 3-year event rates for MI/stroke/vascular death/rehospitalization were 25.5 vs. 40.5% ( P < 0.001). Conclusion Despite contemporary therapy, outpatients with symptomatic atherothrombotic vascular disease experience high rates of recurrent vascular events and rehospitalizations.
- Published
- 2009