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

    Access Status
    Fulltext not available
    Authors
    Reid, Christopher
    Ademi, Z.
    Nelson, M.
    Connor, G.
    Chew, D.
    Shiel, L.
    Smeath, A.
    de Looze, F.
    Steg, P.
    Bhatt, D.
    Lie, D.
    Date
    2012
    Type
    Journal Article
    
    Metadata
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    Citation
    Reid, C. and Ademi, Z. and Nelson, M. and Connor, G. and Chew, D. and Shiel, L. and Smeath, A. et al. 2012. Outcomes from the REACH registry for Australian general practice patients with or at high risk of atherothrombosis. Medical Journal of Australia. 196 (3): pp. 193-197.
    Source Title
    Medical Journal of Australia
    DOI
    10.5694/mja11.10731
    ISSN
    0025-729X
    School
    Department of Health Policy and Management
    URI
    http://hdl.handle.net/20.500.11937/11621
    Collection
    • Curtin Research Publications
    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.

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