Three-year follow-up and event rates in the international REduction of Atherothrombosis for Continued Health Registry

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, Ph Gabriel Steg

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182 Scopus citations

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 resultsREACH 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.

Original languageEnglish (US)
Pages (from-to)2318-2326
Number of pages9
JournalEuropean heart journal
Volume30
Issue number19
DOIs
StatePublished - Oct 1 2009

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Keywords

  • Atherothrombosis
  • Cerebrovascular disease
  • Coronary artery disease
  • Peripheral arterial disease
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Alberts, M. J., Bhatt, D. L., Mas, J. L., Ohman, E. M., Hirsch, A. T., Röther, J., Salette, G., Goto, S., Smith, S. C., Liau, C. S., Wilson, P. W. F., & Steg, P. G. (2009). Three-year follow-up and event rates in the international REduction of Atherothrombosis for Continued Health Registry. European heart journal, 30(19), 2318-2326. https://doi.org/10.1093/eurheartj/ehp355