REACH Registry Demonstrates That Multiple Arterial Disease Locations Sharply Increase the Risk of Major CV Events in Outpatients With Atherothrombosis



    PARIS, March 20 /CNW/ -

    -   The Reduction of Atherothrombosis for Continued Health (REACH)
    -   Registry 1-Year Results

    The REACH Registry 1-year results paper published today in the Journal of
the American Medical Association (JAMA) show that outpatients with
atherothrombosis have a surprisingly high risk of death or major
cardiovascular illness, especially if more than one vascular bed is diseased.
REACH also documented high event rates that accrued almost linearly over time
- in contrast to the sharp rise followed by a leveling off of event rates that
is usually seen in patients discharged from hospital after acute events. REACH
is the first international outpatient registry to characterize the real-world
burden of atherothrombotic disease worldwide (REACH).

    
    -   Within a year, around one in seven patients will die, experience a
        heart attack or stroke, or be hospitalized from a complication
        arising from atherothrombosis - clogged arteries in the heart, brain
        or legs.

    -   Patients with atherothrombosis in the legs (peripheral arterial
        disease: PAD) have a one in five (21%) chance of dying, having a
        heart attack or stroke or being hospitalized due to cardiovascular
        reasons within one year.

    -   Over the same period of time, for patients who have atherothrombosis
        in more than one area (heart, brain and/or legs) this risk doubles.

    -   The risk increases dependent on the number of arterial beds affected;
        with 5% event rate for patients with risk factors only, 13% for
        patients with risk factors and one diseased vascular bed, 22% for
        patients with risk factors and two diseased vascular beds and 26% for
        patients with risk factors and three diseased vascular beds

    -   REACH demonstrates that up to 1.75 million CV events could be seen in
        those patients with multiple arterial disease in the US alone over
        the next 12 months(*)
    

    For patients without a history of coronary, cerebrovascular or PAD, but
who have at least 3 risk factors for developing these conditions (such as
diabetes, high blood pressure, high cholesterol and smoking), around 5 percent
had a major event or were hospitalized within 1 year.
    "I find these event rates to be high, given that we are dealing with a
stable outpatient population treated with contemporary therapy," said Dr
Gabriel Steg, professor of cardiology at Hopital Bichat-Claude Bernard, Paris,
on behalf of the REACH Registry's Scientific Council. "The impact of
polyvascular disease on the risk of event in REACH shows that it is critical
that we stop viewing atherothrombosis as a disease of a specific medical
specialty - cardiology, neurology, or vascular disease - instead we must view
it as a 'global' disease. Doctors' adherence to evidence-based guidelines for
treatment are important to manage the risk for this group of patients," Dr.
Steg said.

    Objectives and scope of REACH

    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, such as, high
cholesterol, high blood pressure, smoking, and diabetes, 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 underlying cause of heart attack, stroke and PAD

    Atherothrombosis occurs when a blood clot (thrombus) forms on a ruptured
plaque (atheroma) in the wall of a blood vessel. Plaques consist of fatty
acids and cholesterol, calcium and other materials.
    The rupture of plaques and the subsequent development of a clot can cause
partial or complete blockage of an artery in various parts of the body. When a
vessel in the heart is partially or completely blocked by a clot the result
can be a heart attack. In the brain, the same process can cause a stroke.
Elsewhere in the body, this process can lead to reduction or blockage of blood
flow in the arteries of the legs - PAD - a significant risk factor for heart
attack or stroke.
    Atherothrombosis is thus the common thread linking heart attack, stroke
and peripheral arterial disease.

    Notes to Editors:

    REACH Registry

    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 registry follows more than 60,000
patients over 4 years, involving 44 countries and 5,000 physician
investigators. The REACH registry aims to improve the assessment and
management of patients with a history of coronary artery disease (CAD),
cerebrovascular disease (Stroke/TIA), peripheral arterial disease (PAD), and
those with a combination of high risk factors.
    The REACH Registry is sponsored by Sanofi-Aventis, Britsol-Myers Squibb,
and the Waksman Foundation (Tokyo, Japan), who assisted with the design and
conduct of the study and data collection.

    REACH Registry Baseline Publication:

    DL. Bhatt, PG Steg, EM.Ohman, AT.Hirsch, Y.Ikeda, JL.Mas, S.Goto,
C-S.Liau, AJ.Richard, J.Rother, PWF.Wilson, on behalf of the REACH Registry
Investigators. International Prevalence, Recognition, and Treatment of
Cardiovascular Risk Factors in Outpatients with Atherothrombosis. JAMA
2006;295:180-9.

    REACH Registry Scientific Council:

    
    -   Philippe Gabriel Steg, AP-HP, Hopital Bichat-Claude Bernard, Paris,
        France (co-chair)

    -   Deepak L. Bhatt, Cleveland Clinic Foundation, Cleveland, USA (co-
        chair)

    -   E. Magnus Ohman, Duke University, Durham, NC, USA

    -   Joachim Rother, Universitat-Klinikum Minden, Minden, Germany

    -   Peter F. Wilson, Medical University of South Carolina, Charleston,
        USA

    (*) a total of approx. 1.75 million events in the PAD population alone
        (comprising, CV death, MI, stroke and hospitalization for an
        atherothrombotic event)
    

    For further information on the REACH Registry please visit
www.REACHRegistry.org.





For further information:

For further information: Anna Gray, REACH Registry Editorial Support
Group, Tel: (during ACC): +44-7816-280576, Office: +44-(0)-207-300-6281;
Professeur Philippe Gabriel STEG, MD, FESC, FACC, FACCP, Departement de
Cardiologie, Hopital Bichat-Claude Bernard, Assistance Publique - Hopitaux de
Paris, 46 rue Henri Huchard, 75018 Paris, France, Tel: +33-(0)-1-40-25-86-68,
Cell: +33-(0)-6-07-24-62-24, Fax: +33-(0)-1-40-25-88-65, e-mail:
gabriel.steg@bch.aphp.fr

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