Cardiovascular risk profile and outcome of patients with abdominal aortic aneurysm in out-patients with atherothrombosis: data from the Reduction of Atherothrombosis for Continued Health (REACH) Registry.
OBJECTIVE
Datasets regarding patients with abdominal aortic aneurysm (AAA) have almost universally been restricted to single geographic regions. We aimed to obtain data on the risk factor profile and cardiovascular (CV) co-morbidity among multi-ethnic patients with known AAA in the global REACH (REduction of Atherothrombosis for Continued Health) Registry.


METHODS
The REACH Registry is an international, prospective, observational out-patient registry enrolling out-patients >/=45 years of age with established coronary artery disease (CAD), cerebrovascular disease (CVD) or peripheral arterial disease (PAD) or with at least three atherothrombotic risk factors. This report includes observations pertaining to 68,236 out-patients enrolled in 44 countries.


METHODS
Gender, ethnic origin, CV risk factors, established atherosclerotic disease (CAD, CVD and PAD) at baseline, and CV outcome events at 1-year were compared in patients with and without AAA.


RESULTS
An AAA was reported in 1722 (2.5%) of 68,236 out-patients enrolled in the REACH Registry. Older age (73 +/- 8 vs 68 +/- 10, P < .0001), male gender (81% vs 63%, P < .0001), White ethnicity (79% vs 67%, P < .0001) and a history of smoking (81% vs 55%, P < .0001) were independently related to the diagnosis of AAA. There was a weaker association with hypertension or hypercholesterolemia, and an inverse relation with diabetes. Fatal and non-fatal coronary and cerebrovascular event rates were not different between the AAA and non-AAA cohorts, but individuals with AAA suffered increased rates of other cardiovascular deaths (1.39% vs 0.94%, P = .0135), hospitalizations for atherothrombotic events (14.1% vs 9.3%, P < .0001) due to increased rates of revascularization procedures, and new or worsening PAD (3.7% vs 1.3%, P < .0001) at 1-year follow-up.


CONCLUSIONS
This study, the largest published to date, presents the CV risk profile and outcome of patients with an established diagnosis of AAA from a cohort of patients with either overt manifestations of CV disease or multiple risk factors, and further defines these patients in a multi-ethnic, global context.
Baumgartner
Iris
I
Department of Clinical and Interventional Angiology, Swiss Cardiovascular Centre, Angiology Division, University Hospital, Bern, Switzerland.
Hirsch
Alan T
AT
Abola
Maria Teresa B
MT
Cacoub
Patrice P
PP
Poldermans
Don
D
Steg
Philippe Gabriel
PG
Creager
Mark A
MA
Bhatt
Deepak L
DL
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications*; D050197:Atherosclerosis / Q000150:complications* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D010045:Outpatients; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications* / Q000453:epidemiology