Cardiovascular event rates in patients with cerebrovascular disease and atherothrombosis at other vascular locations: results from 1-year outcomes in the Japanese REACH Registry.
The REduction of Atherothrombosis for Continued Health (REACH) Registry is a large, international, prospective cohort of patients with atherothrombosis or multiple (>or=3) risk factors (MRFs) for atherothrombosis. Japanese patients (n=5193) were enrolled into the REACH registry between August and December 2004. One-year event rate in patients with cerebrovascular disease (CVD) was compared with that of patients with symptomatic atherothrombosis at other locations. After one year (n=5021), patients with CVD (n=1962) experienced a higher rate of non-fatal strokes than patients with coronary artery disease (CAD), peripheral artery disease (PAD) or MRFs alone (2.77% vs. 1.28%, 2.07% and 1.56%, respectively), but a lower rate of non-fatal myocardial infarction (0.45% vs. 1.31%, 0.77% and 0.66%, respectively). Patients with CVD plus disease in >or=1 other vascular bed had higher rates of cardiovascular events than patients with CVD alone. Overall, event rates including non-fatal stroke, non-fatal myocardial infarction and cardiovascular death were higher for patients with CVD and PAD than for patients with CVD and CAD. Asymptomatic carotid stenosis >or=70% and ankle-brachial index <0.9 were significant predisposing factors for stroke. Patients with CVD and co-existing atherothrombotic diseases had a high risk of recurrent events, including events arising in other vascular beds than originally diagnosed.
Uchiyama
Shinichiro
S
Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. suchiyam@nij.twmu.ac.jp
Goto
Shinya
S
Matsumoto
Masayasu
M
Nagai
Ryozo
R
Origasa
Hideki
H
Yamazaki
Tsutomu
T
Shigematsu
Hiroshi
H
Shimada
Kazuyuki
K
Yamada
Nobuhiro
N
Bhatt
Deepak L
DL
Steg
P Gabriel
PG
Ikeda
Yasuo
Y
D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000401:mortality* / Q000503:physiopathology; D016893:Carotid Stenosis / Q000401:mortality / Q000503:physiopathology; D015984:Causality; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000401:mortality* / Q000503:physiopathology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000401:mortality* / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology; D017063:Outcome Assessment, Health Care; D016491:Peripheral Vascular Diseases / Q000401:mortality / Q000503:physiopathology; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013997:Time Factors