Cardiovascular ischemic event rates in outpatients with symptomatic atherothrombosis or risk factors in the United States: Insights from the REACH registry

Kim A. Eagle, Alan T. Hirsch, Robert M. Califf, Mark J. Alberts, P. Gabriel Steg, Christopher P. Cannon, Danielle M. Brennan, Deepak L. Bhatt

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

BACKGROUND: Atherothrombosis, defined as coronary artery, cerebrovascular, and peripheral arterial disease, is the leading cause of death in the United States. Limited data are available from outpatient populations to describe contemporary cardiovascular ischemic event rates and associated use of risk reduction treatments in patients with clinically manifest, or at risk for, atherothrombosis. The REduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective, observational study of patients with either documented atherothrombotic syndromes or 3 or more risk factors designed to fill this knowledge gap. METHODS: Baseline demographics and 1-year outcomes were evaluated for US patients enrolled in the REACH Registry. Multivariate analytic models were constructed using baseline characteristics to determine independent predictors of 1-year event rates. RESULTS: In the United States, 25,686 patients were enrolled into the registry. Among symptomatic patients (n = 19,069), 19% had disease in ≥1 arterial bed. As of July 2006, 1-year outcomes were available for 93.4% (n = 23,985) of patients. The composite cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke event rate was 4.3% for the overall population and highest in patients with triple bed disease (9.9%). There was a relatively high use of risk reduction medications among symptomatic patients. However, opportunity for improvement remains. Approximately 9% of symptomatic patients were not using any antithrombotic, 7% were not using any antihypertensive agents, and 17% were not taking a lipid-lowering agent, whereas >80% of patients suffered from hypertension or dyslipidemia. CONCLUSIONS: US patients with established atherothrombotic disease continue to experience high cardiovascular ischemic event rates; these rates increase in close association with polyvascular disease. Despite the use of risk reduction interventions, ideal secondary prevention of ischemic events has not been achieved.

Original languageEnglish (US)
Pages (from-to)91-97
Number of pages7
JournalCritical Pathways in Cardiology
Volume8
Issue number2
DOIs
StatePublished - Jun 2009

Fingerprint

Registries
Outpatients
Health
Risk Reduction Behavior
Peripheral Arterial Disease
Dyslipidemias
Secondary Prevention
Antihypertensive Agents
Population
Observational Studies
Cause of Death
Coronary Vessels
Stroke
Myocardial Infarction
Demography
Prospective Studies
Hypertension
Lipids

Keywords

  • Atherosclerotic risk
  • Atherothrombosis
  • Cerebrovascular disease
  • Coronary artery disease
  • Peripheral arterial disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cardiovascular ischemic event rates in outpatients with symptomatic atherothrombosis or risk factors in the United States : Insights from the REACH registry. / Eagle, Kim A.; Hirsch, Alan T.; Califf, Robert M.; Alberts, Mark J.; Steg, P. Gabriel; Cannon, Christopher P.; Brennan, Danielle M.; Bhatt, Deepak L.

In: Critical Pathways in Cardiology, Vol. 8, No. 2, 06.2009, p. 91-97.

Research output: Contribution to journalArticle

Eagle, Kim A. ; Hirsch, Alan T. ; Califf, Robert M. ; Alberts, Mark J. ; Steg, P. Gabriel ; Cannon, Christopher P. ; Brennan, Danielle M. ; Bhatt, Deepak L. / Cardiovascular ischemic event rates in outpatients with symptomatic atherothrombosis or risk factors in the United States : Insights from the REACH registry. In: Critical Pathways in Cardiology. 2009 ; Vol. 8, No. 2. pp. 91-97.
@article{c0091929a1b443d0bdc2c293dd1b0055,
title = "Cardiovascular ischemic event rates in outpatients with symptomatic atherothrombosis or risk factors in the United States: Insights from the REACH registry",
abstract = "BACKGROUND: Atherothrombosis, defined as coronary artery, cerebrovascular, and peripheral arterial disease, is the leading cause of death in the United States. Limited data are available from outpatient populations to describe contemporary cardiovascular ischemic event rates and associated use of risk reduction treatments in patients with clinically manifest, or at risk for, atherothrombosis. The REduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective, observational study of patients with either documented atherothrombotic syndromes or 3 or more risk factors designed to fill this knowledge gap. METHODS: Baseline demographics and 1-year outcomes were evaluated for US patients enrolled in the REACH Registry. Multivariate analytic models were constructed using baseline characteristics to determine independent predictors of 1-year event rates. RESULTS: In the United States, 25,686 patients were enrolled into the registry. Among symptomatic patients (n = 19,069), 19{\%} had disease in ≥1 arterial bed. As of July 2006, 1-year outcomes were available for 93.4{\%} (n = 23,985) of patients. The composite cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke event rate was 4.3{\%} for the overall population and highest in patients with triple bed disease (9.9{\%}). There was a relatively high use of risk reduction medications among symptomatic patients. However, opportunity for improvement remains. Approximately 9{\%} of symptomatic patients were not using any antithrombotic, 7{\%} were not using any antihypertensive agents, and 17{\%} were not taking a lipid-lowering agent, whereas >80{\%} of patients suffered from hypertension or dyslipidemia. CONCLUSIONS: US patients with established atherothrombotic disease continue to experience high cardiovascular ischemic event rates; these rates increase in close association with polyvascular disease. Despite the use of risk reduction interventions, ideal secondary prevention of ischemic events has not been achieved.",
keywords = "Atherosclerotic risk, Atherothrombosis, Cerebrovascular disease, Coronary artery disease, Peripheral arterial disease",
author = "Eagle, {Kim A.} and Hirsch, {Alan T.} and Califf, {Robert M.} and Alberts, {Mark J.} and Steg, {P. Gabriel} and Cannon, {Christopher P.} and Brennan, {Danielle M.} and Bhatt, {Deepak L.}",
year = "2009",
month = "6",
doi = "10.1097/HPC.0b013e3181a84613",
language = "English (US)",
volume = "8",
pages = "91--97",
journal = "Critical Pathways in Cardiology",
issn = "1535-282X",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Cardiovascular ischemic event rates in outpatients with symptomatic atherothrombosis or risk factors in the United States

T2 - Insights from the REACH registry

AU - Eagle, Kim A.

AU - Hirsch, Alan T.

AU - Califf, Robert M.

AU - Alberts, Mark J.

AU - Steg, P. Gabriel

AU - Cannon, Christopher P.

AU - Brennan, Danielle M.

AU - Bhatt, Deepak L.

PY - 2009/6

Y1 - 2009/6

N2 - BACKGROUND: Atherothrombosis, defined as coronary artery, cerebrovascular, and peripheral arterial disease, is the leading cause of death in the United States. Limited data are available from outpatient populations to describe contemporary cardiovascular ischemic event rates and associated use of risk reduction treatments in patients with clinically manifest, or at risk for, atherothrombosis. The REduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective, observational study of patients with either documented atherothrombotic syndromes or 3 or more risk factors designed to fill this knowledge gap. METHODS: Baseline demographics and 1-year outcomes were evaluated for US patients enrolled in the REACH Registry. Multivariate analytic models were constructed using baseline characteristics to determine independent predictors of 1-year event rates. RESULTS: In the United States, 25,686 patients were enrolled into the registry. Among symptomatic patients (n = 19,069), 19% had disease in ≥1 arterial bed. As of July 2006, 1-year outcomes were available for 93.4% (n = 23,985) of patients. The composite cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke event rate was 4.3% for the overall population and highest in patients with triple bed disease (9.9%). There was a relatively high use of risk reduction medications among symptomatic patients. However, opportunity for improvement remains. Approximately 9% of symptomatic patients were not using any antithrombotic, 7% were not using any antihypertensive agents, and 17% were not taking a lipid-lowering agent, whereas >80% of patients suffered from hypertension or dyslipidemia. CONCLUSIONS: US patients with established atherothrombotic disease continue to experience high cardiovascular ischemic event rates; these rates increase in close association with polyvascular disease. Despite the use of risk reduction interventions, ideal secondary prevention of ischemic events has not been achieved.

AB - BACKGROUND: Atherothrombosis, defined as coronary artery, cerebrovascular, and peripheral arterial disease, is the leading cause of death in the United States. Limited data are available from outpatient populations to describe contemporary cardiovascular ischemic event rates and associated use of risk reduction treatments in patients with clinically manifest, or at risk for, atherothrombosis. The REduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective, observational study of patients with either documented atherothrombotic syndromes or 3 or more risk factors designed to fill this knowledge gap. METHODS: Baseline demographics and 1-year outcomes were evaluated for US patients enrolled in the REACH Registry. Multivariate analytic models were constructed using baseline characteristics to determine independent predictors of 1-year event rates. RESULTS: In the United States, 25,686 patients were enrolled into the registry. Among symptomatic patients (n = 19,069), 19% had disease in ≥1 arterial bed. As of July 2006, 1-year outcomes were available for 93.4% (n = 23,985) of patients. The composite cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke event rate was 4.3% for the overall population and highest in patients with triple bed disease (9.9%). There was a relatively high use of risk reduction medications among symptomatic patients. However, opportunity for improvement remains. Approximately 9% of symptomatic patients were not using any antithrombotic, 7% were not using any antihypertensive agents, and 17% were not taking a lipid-lowering agent, whereas >80% of patients suffered from hypertension or dyslipidemia. CONCLUSIONS: US patients with established atherothrombotic disease continue to experience high cardiovascular ischemic event rates; these rates increase in close association with polyvascular disease. Despite the use of risk reduction interventions, ideal secondary prevention of ischemic events has not been achieved.

KW - Atherosclerotic risk

KW - Atherothrombosis

KW - Cerebrovascular disease

KW - Coronary artery disease

KW - Peripheral arterial disease

UR - http://www.scopus.com/inward/record.url?scp=68049097214&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68049097214&partnerID=8YFLogxK

U2 - 10.1097/HPC.0b013e3181a84613

DO - 10.1097/HPC.0b013e3181a84613

M3 - Article

C2 - 19417637

AN - SCOPUS:68049097214

VL - 8

SP - 91

EP - 97

JO - Critical Pathways in Cardiology

JF - Critical Pathways in Cardiology

SN - 1535-282X

IS - 2

ER -