REACH shows patients suffer high risk of death.
New analyzes from the REACH (Reduction of Atherothrombosis for Continued Health) Registry presented at the European Society of Cardiology meeting in Vienna, Austria, has re-affirmed the one-year results first published in the Journal of the American Medical Association in March 2007. Outpatients with atherothrombosis have a high risk of death or major cardiovascular illness, especially in patients who have peripheral arterial disease (PAD). The results were presented by lead author, Dr Alan T Hirsch, Professor of Epidemiology and Community Health, University of Minnesota School of Public Health; and Director of the Minneapolis Heart Institute’s Vascular Medicine Program, Abbott Northwestern’s Vascular Center in Minneapolis, MN. The overall aim of the REACH Registry is to improve the assessment and management of stroke, heart attack and associated risk factors for atherothrombosis. It is the largest and most geographically extensive global registry of patients at risk of atherothrombosis, having recruited over 68,000 patients in 44 countries, covering six regions. Latin America, Asia, the Middle East, Australia, Europe and North America – and involving over 5,000 physician investigators. The REACH Registry includes a broad spectrum of patients with atherothrombosis; documenting the health status and treatment of people at risk of atherothrombosis; monitoring how they are affected; and measuring the burden of the disease. Patients included in the REACH Registry either have several of the risk factors that can lead to atherothrombosis or have a previous history of heart attack, stroke or PAD. Participation in the REACH Registry is strictly voluntary. In addition, the REACH Registry is based in a real-life setting and seeks to increase overall understanding of atherothrombotic disease across several medical specialities (cardiology, neurology, internal medicine, vascular medicine and office-based primary care physicians), which allows for a more thorough assessment of the real-world burden of the disease. The REACH Registry is the first outpatient registry to characterize real-world event rates and treatment patterns in a broad spectrum of patients with atherothrombosis worldwide. The REACH Registry aims to improve the assessment and management of patients with a history of coronary artery disease (CAD), cerebrovascular disease (stroke/TIA), PAD, and those with a combination of high risk factors. Hirsch commented, “PAD has long been known to represent a form of artery disease that carries a high risk. The international REACH Registry demonstrates that this cardiovascular risk in patients with PAD remains remarkable in every nation, and is undoubtedly associated with a high personal, family, community, and public health cost. One in three individuals with PAD in office practice face a short-term chance of dying, having a heart attack or stroke or being hospitalized within two years. One in ten will die in this short time frame. Therefore initiating therapy without delay to reduce this risk is essential.” Despite improved PAD awareness, treatment and diagnosis during the past five years, Hirsch and investigators hypothesized that cardiovascular disease event rates would remain high, and that complacency in treating this disease was not merited. The analysis of international individuals enrolled in REACH found this to be true, and all individuals with PAD, regardless of symptom status or past use of leg angioplasty or leg bypass remained at high risk. “The REACH Registry continues to demonstrate the real-world burden of atherothrombotic disease worldwide. In the case of PAD, further analysis has reemphasized the need for doctors to adhere to evidence-based guidelines for treatment like long-term antiplatelet therapy with aspirin or clopidogrel,” said Dr Gabriel Steg, Professor of Cardiology at Hopital Bichat-Claude Bernard, Paris, France, on behalf of the REACH Registry’s Scientific Council. “But first diagnosis must happen earlier and to do this the tools need to be more readily available and reimbursed, especially in Europe.”