title: Outcomes from the REACH Registry for Australian general practice patients with or at high risk of atherothrombosis.
abstract: OBJECTIVE
  To report on 1-year cardiovascular (CV) event rates in patients with established cardiovascular disease (CVD) or with multiple cardiovascular risk factors.
  
  
  METHODS
  Prospective cohort study of 2873 patients at high risk of atherothrombosis based on the presence of multiple risk factors and overt coronary artery disease (CAD), cerebrovascular disease (CerVD) or peripheral arterial disease (PAD) presenting to 273 Australian general practitioners; this study was conducted as part of the international REACH Registry.
  
  
  METHODS
  One-year rates of cardiovascular death, myocardial infarction, stroke, and hospitalisation for cardiovascular procedures.
  
  
  RESULTS
  The cardiovascular death rate at 1 year was 1.4%. The combined cardiovascular death, non-fatal MI, stroke and hospitalisation rate for vascular disease affecting one location at 1 year was 11%. Even for patients with no overt disease, but with multiple risk factors, the 1-year combined event rate was 4.2%. The highest combined event rate was in patients with PAD (21.0%), and in patients with atherothrombotic disease identified in all three locations (coronary arteries, cerebrovascular system and peripheral arteries) at 39%.
  
  
  CONCLUSIONS
  The rate of clinical events in community-based patients with stable atherothrombotic disease increases dramatically with the severity of disease and the number of vascular beds involved. Where disease was evident in all three locations, and for patients with PAD alone, the 1-year risk of cardiovascular events was substantially increased. Poor adherence to statin therapy in the secondary preventive setting is a major treatment gap that needs to be closed; the influences of obesity and diabetes warrant further investigation.
authors.affiliation: CCRE Therapeutics, Monash University, Melbourne, VIC, Australia. chris.reid@monash.edu
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Reid
authors.forename: Zanfina
authors.initials: Z
authors.lastname: Ademi
authors.forename: Mark R
authors.initials: MR
authors.lastname: Nelson
authors.forename: Greg
authors.initials: G
authors.lastname: Connor
authors.forename: Derek P
authors.initials: DP
authors.lastname: Chew
authors.forename: Louise
authors.initials: L
authors.lastname: Shiel
authors.forename: Ana
authors.initials: A
authors.lastname: Smeath
authors.forename: Fred
authors.initials: F
authors.lastname: De Looze
authors.forename: Ph Gabriel
authors.initials: PG
authors.lastname: Steg
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: Danny
authors.initials: D
authors.lastname: Liew
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000517:prevention & control*; D001315:Australia / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D058006:General Practice; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D013927:Thrombosis / Q000517:prevention & control*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors