Risk-factor profile, drug usage and cardiovascular events within a year in patients with and at high risk of atherothrombosis recruited from Asia as compared with those recruited from non-Asian regions: a substudy of the REduction of Atherothrombosis for Continued Health (REACH) registry.
OBJECTIVE
To clarify the differences in the baseline characteristics, prevalence and incidence of atherothrombosis in patients recruited from Asia versus non-Asian regions.


METHODS
International Prospective Cohort Study.


METHODS
Region focused substudy.


METHODS
The Reduction of Atherothrombosis for Continued Health (REACH) Registry recruited 68 236 stable outpatients with established atherothrombosis or ≥3 atherothrombotic risk factors from 44 countries.


METHODS
No intervention.


METHODS
Risk factors, use of medications, vascular disease bed location, and 1-year cardiovascular (CV) outcomes (CV death, myocardial infarction, stroke).


RESULTS
The percentages of patients recruited with CVD (Cerebrovascular Disease) were higher in Asia (41.0%) than in non-Asian regions (25.1%) (p<0.0001). The prevalence of diabetes mellitus was higher in Asia (46.6%) than in non-Asian regions (43.3%) (p<0.0001) despite the former having a lower body mass index (BMI) (24.4±3.9 vs 28.8±5.6) (p<0.0001). The combined endpoint of CV death/myocardial infarction/stroke of patients recruited from non-Asian regions of 4.38% (95% CI 4.20 to 4.56) is equivalent to those from the Asian region excluding Japan of 4.65% (95% CI 4.04 to 5.25), but that is significantly lower in patients recruited from Japan of 3.40% (95% CI 2.76 to 4.04, p<0.05).


CONCLUSIONS
There is a higher prevalence of CVD and higher prevalence of diabetus mellitus with lower body mass index in patients recruited from the Asian region as compared those recruited from non-Asian regions. The CV event rate in patients recruited from non-Asian regions is equivalent to that of patients recruited from the Asian region excluding Japan, but significantly lower in patients recruited from Japan.
Department of Medicine (Cardiology), Tokai University School of Medicine, Isehara, Japan.
S
S
Goto
Department of Life Science and Medical Bioscience, Waseda University, Tokyo, Japan.
Y
Y
Ikeda
Department of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
J C N
JC
Chan
Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, USA.
P W F
PW
Wilson
Department of General Medicine, National University Hospital, Singapore.
T Cheng
TC
Yeo
Department of Cardiology, Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
C S
CS
Liau
Section of Vascular Medicine, Division of Clinical Cardiology, Philippine Heart Center, Quezon City, Philippines.
M T
MT
Abola
Sanofi-Aventis, Paris, France.
G
G
Salette
Department of Cardiology, Hôpital Bichat-Claude Bernard, Université Paris, Paris, France.
P G
PG
Steg
10VA Boston Healthcare System and Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
D L
DL
Bhatt
Atherothrombosis; atherosclerosis; epidemiology; geographic variation; mortality; outcomes; platelets; risk factor; thrombosis