Cardiovascular risk factor control and outcomes in peripheral artery disease patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry.
OBJECTIVE
To examine differences in risk factor (RF) management between peripheral artery disease (PAD) and coronary artery (CAD) or cerebrovascular disease (CVD), as well as the impact of RF control on major 1-year cardiovascular (CV) event rates.


METHODS
The REACH Registry recruited >68000 outpatients aged >or=45 years with established atherothrombotic disease or >or=3 RFs for atherothrombosis. The predictors of RF control that were evaluated included: (1) patient demographics, (2) mode of PAD diagnosis, and (3) concomitant CAD and/or CVD.


RESULTS
RF control was less frequent in patients with PAD (n=8322), compared with those with CAD or CVD (but no PAD, n=47492) [blood pressure; glycemia; total cholesterol; smoking cessation (each P<0.001)]. Factors independently associated with optimal RF control in patients with PAD were male gender (OR=1.9); residence in North America (OR=3.5), Japan (OR=2.5) or Latin America (OR=1.5); previous coronary revascularization (OR=1.3); and statin use (OR=1.4); whereas prior leg amputation was a negative predictor (OR=0.7) (P<0.001). Optimal RF control was associated with fewer 1-year CV ischemic symptoms or events.


CONCLUSIONS
Patients with PAD do not achieve RF control as frequently as individuals with CAD or CVD. Improved RF control is associated with a positive impact on 1-year CV event rates.
Cacoub
Patrice P
PP
Pierre and Marie Curie University-Paris 6, and AP HP, Hospital La Pitié-Salpêtrière, Paris, France. patrice.cacoub@psl.aphp.fr
Abola
Maria Teresa B
MT
Baumgartner
Iris
I
Bhatt
Deepak L
DL
Creager
Mark A
MA
Liau
Chiau-Suong
CS
Goto
Shinya
S
Röther
Joachim
J
Steg
P Gabriel
PG
Hirsch
Alan T
AT
D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000628:therapy; D003324:Coronary Artery Disease / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000628:therapy*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications / Q000628:therapy*; D013997:Time Factors