Outcomes from the REACH Registry for Australian general practice patients with or at high risk of atherothrombosis

Reid, Christopher M., Ademi, Zanfina, Nelson, Mark R., Connor, Greg, Chew, Derek P., Shiel, Louise, Smeath, Ana, De Looze, Fred, Steg, Gabriel, Bhatt, Deepak L, Liew, Danny and REACH Registry Investigators (2012) Outcomes from the REACH Registry for Australian general practice patients with or at high risk of atherothrombosis. Medical Journal of Australia, 196 3: 193-197. doi:10.5694/mja11.10731


Author Reid, Christopher M.
Ademi, Zanfina
Nelson, Mark R.
Connor, Greg
Chew, Derek P.
Shiel, Louise
Smeath, Ana
De Looze, Fred
Steg, Gabriel
Bhatt, Deepak L
Liew, Danny
REACH Registry Investigators
Total Author Count Override 11
Title Outcomes from the REACH Registry for Australian general practice patients with or at high risk of atherothrombosis
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
1326-5377
Publication date 2012-02-01
Sub-type Article (original research)
DOI 10.5694/mja11.10731
Volume 196
Issue 3
Start page 193
End page 197
Total pages 5
Place of publication Strawberry Hills, NSW, Australia
Publisher Australasian Medical Publishing Company
Collection year 2013
Language eng
Formatted abstract
Objective:
To report on 1-year cardiovascular (CV) event rates in patients with established cardiovascular disease (CVD) or with multiple cardiovascular risk factors.

Design, patients and setting:

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.

Main outcome measures:
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%.

Conclusion:
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.
Keyword Percutaneous Coronary Intervention
Cardiovascular Event Rates
Obesity Paradox
Randomized-Trials
Diabetes Epidemic
Public-Health
Disease
Outpatients
Prevention
Prevalence
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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Created: Mon, 26 Mar 2012, 22:08:06 EST by System User on behalf of Discipline of General Practice