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

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.

CITA DEL ARTÍCULO  Med Clin (Barc). 2009 Apr 18;132(14):537-44