Three-year follow-up and event rates in the international REduction of Atherothrombosis for Continued Health Registry.
OBJECTIVE
To determine 3-year event rates in outpatients with vascular disease enrolled in the REduction of Atherothrombosis for Continued Health (REACH) Registry.


RESULTS
REACH 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).


CONCLUSIONS
Despite contemporary therapy, outpatients with symptomatic atherothrombotic vascular disease experience high rates of recurrent vascular events and rehospitalizations.
Alberts
Mark J
MJ
Department of Neurology, Northwestern University Medical School, 710 N Lake Shore Drive, Room 1420, Chicago, IL 60611, USA. m-alberts@northwestern.edu
Bhatt
Deepak L
DL
Mas
Jean-Louis
JL
Ohman
E Magnus
EM
Hirsch
Alan T
AT
Röther
Joachim
J
Salette
Geneviève
G
Goto
Shinya
S
Smith
Sidney C
SC
Liau
Chiau-Suong
CS
Wilson
Peter W F
PW
Steg
Ph Gabriel
PG
D000368:Aged; D000553:Ambulatory Care / Q000592:standards*; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000517:prevention & control*; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D009765:Obesity / Q000150:complications; D016491:Peripheral Vascular Diseases / Q000209:etiology; D012042:Registries; D012307:Risk Factors; D055502:Secondary Prevention; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000209:etiology
D000925:Anticoagulants; D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents