title: Cardiovascular event rates in patients with cerebrovascular disease and atherothrombosis at other vascular locations: results from 1-year outcomes in the Japanese REACH Registry.
abstract: 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.
authors.affiliation: Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. suchiyam@nij.twmu.ac.jp
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Uchiyama
authors.forename: Shinya
authors.initials: S
authors.lastname: Goto
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shigematsu
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yamada
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: P Gabriel
authors.initials: PG
authors.lastname: Steg
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ikeda
mesh_terms: 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