[Cardiovascular complications at 1-year of follow-up in patients with atherothrombosis. On behalf of Spain's REACH Registry]

Abstract

Background and objective: The REACH Registry is the largest worldwide designed to obtain information on cardiovascular risk factor control and preventive treatment in a population who have, or are at risk of having, symptoms of atherothrombosis. The objective of this study is to show the results of cardiovascular events obtained in a sample of the Spanish population at one year follow-up and intervention.

Material and method: The REACH Spain registry is a prospective cohort study of subjects with vascular risk factors (ORF) for atherothrombosis or with symptomatic vascular disease (VD): coronary artery disease (CAD) and/or cerebrovascular disease (CVD) and/or peripheral artery disease (PAD). The main outcome measures were rates of all-cause mortality, cardiovascular (CV) death, and the overall combined CV death, myocardial infarction (MI), or stroke and CV hospitalization at one year follow-up.

Results: In Spain 2,516 patients were recruited and 2,252 completed one year follow-up, the mean age was 68,1 (73,8% men), 11,6% of subjects with ORF and 88,5% with VD, 55% with CAD, 33% with CVD and 17% with PAD. The annual rate of all-cause mortality in VD and ORF groups were 3,57% and 1,98% (NS) respectively, while for CV death they were 2,69% and 0,62% (P<.05) and for overall combined CV death myocardial infarction (MI), or stroke and CV hospitalization they were 15,34% and 5,47% (P=.0001). The annual rate of CV death for CAD, CVD and PAD groups were 3,47%, 2,78% and 1,46% respectively, and for the overall combined CV death, myocardial infarction (MI) , or stroke and CV hospitalization they were 18,52%, 13,75% and 14,52%. These event rates increased with the number of symptomatic arterial disease locations from 0,1,2 or 3 for CV death (0,62%, 2,46%, 3,55% and 4,32%, respectively P<.05) and for overall combined CV death myocardial infarction (MI), or stroke and CV hospitalization (5,50%, 4,18%, 20,59% y 19,40%, respectively P<.0001). At one year follow-up, 82,8% of the patients were with at least one antiplatelet drug and 86,2% were receiving lipid-lowering agents.

Conclusions: The REACH Spain Registry at one year follow-up in patients with atherothrombotic disease or at risk of having symptoms of atherothrombosis shows a high rate of all-cause mortality and of overall combined major CV events, which is becoming higher as the number of symptomatic arterial disease locations increases.