Two-year vascular event rates in patients with symptomatic cerebrovascular disease: The reach registry

Narayanaswamy Venketasubramanian, Joachim Röther, Deepak L. Bhatt, Blandine Pasquet, Jean Louis Mas, Mark J. Alberts, Michael D. Hill, Franz Aichner, P. Gabriel Steg

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22 Scopus citations

Abstract

Background and Purpose: Few practice-based studies have reported vascular outcome events among patients with cerebrovascular disease (CeVD). We describe 2-year vascular outcomes among symptomatic CeVD patients from the REduction of Atherothrombosis for Continued Health (REACH) Registry. Methods: Vascular events (stroke; myocardial infarction, MI; cardiovascular death, CV death; hospitalization) were studied among symptomatic CeVD patients from a prospective cohort of stable outpatients with established atherothrombosis or ≥3 atherothrombotic risk factors. Results: Of the 69,055 patients in REACH, 18,992 (28%) had symptomatic CeVD, of which outcome data were available for 18,189 patients. At 2 years, the frequency of non-fatal stroke was 5.93% (95% CI 5.22-6.64), non-fatal MI 2.21% (95% CI 1.65-2.76), CV death 4.45% (95% CI 3.66-5.22), combined vascular endpoint 11.48% (95% CI 10.46-12.49), and all deaths 7.39% (95% CI 6.34-8.42). The frequency of stroke, MI, CV death, or hospitalization for atherothrombotic events was 21.05% (95% CI 20.05-22.03). Event rates were lowest among patients with CeVD alone and highest among patients with CeVD, coronary artery disease, and peripheral artery disease. Other predictors of the primary outcome were increasing age, history of diabetes, current smoking, asymptomatic carotid stenosis, and carotid plaque. Outcomes were similar across geographical regions. Conclusions: Symptomatic CeVD patients encounter high vascular event rates despite treatment. Recurrent nonfatal stroke is more common than nonfatal MI.

Original languageEnglish (US)
Pages (from-to)254-260
Number of pages7
JournalCerebrovascular Diseases
Volume32
Issue number3
DOIs
Publication statusPublished - Sep 2011

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Keywords

  • Atherothrombosis
  • Cerebrovascular disease
  • Epidemiology
  • Risk factors
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Venketasubramanian, N., Röther, J., Bhatt, D. L., Pasquet, B., Mas, J. L., Alberts, M. J., ... Steg, P. G. (2011). Two-year vascular event rates in patients with symptomatic cerebrovascular disease: The reach registry. Cerebrovascular Diseases, 32(3), 254-260. https://doi.org/10.1159/000328650