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

Research output: Contribution to journalArticlepeer-review

198 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 2009

Bibliographical note

Funding Information:
The REACH Registry is sponsored by sanofi-aventis, Bristol-Myers Squibb, and the Waksman Foundation (Tokyo, Japan). Funding to pay the Open Access publication charges for this article was provided by sanofi-aventis and Bristol-Myers-Squibb.

Funding Information:
M.J.A. has received research grants, honoraria, and consulting fees from sanofi-aventis, Bristol-Myers Squibb, AstraZeneca, Schering-Plough, Genentech, Boehringer Ingelheim; honoraria and consulting fees from The Medicines Company, Pfizer, PDL Biopharm Diadexus; and consulting fees from Eli Lilly, Merck, GlaxoSmithKline, Biosite, Cardax.

Funding Information:
E.M.O. has received grant support from Bristol-Myers Squibb, sanofi-aventis, Schering-Plough, Millennium Pharmaceuticals, Eli Lilly, and Berlex; consultancy fees from Inovise, Savacor, Liposcience, Response Biomedical, The Medicines Company, Datascope, and Abiomed; payment for speaker’s bureau from CV Therapeutics and Schering-Plough within the last 3 years and is a shareholder of Inovise, Savacor, and Medtronic.

Funding Information:
A.T.H. has received research grants from Bristol-Myers Squibb and sanofi-aventis, and honoraria from sanofi-aventis.

Funding Information:
S.G. has received honoraria and consulting fees from Eisai, sanofi-aventis, Daiichi-Sankyo, GlaxoSmithKline, Bristol-Myers Squibb, Otsuka, Bayer, Schering-Plough, Takeda, Astellas, AstraZeneca, Novar-tis, and Kowa; has received research grants from Pfizer, Ono, Eisai, Otsuka, Daiichi-Sankyo, sanofi-aventis, Takeda, and Astellas within the past 3 years. S.S. has no disclosures. C.-S.L. has no disclosures.

Funding Information:
Ph.G.S. has received research grant from sanofi-aventis (1999– 2008); is on the speaker’s bureau for Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Menarini, Medtronic, Nycomed, Pierre Fabre, sanofi-aventis, Servier, and The Medicines Company; is on the consulting/advisory boards for Astellas, AstraZe-neca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi-Sankyo, Endotis, GlaxoSmithKline, Medtronic, MSD, Nycomed, sanofi-aventis, Servier, and The Medicines Company; and is a stockholder for Aterovax.

Keywords

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

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