Reid, CM and Ademi, Z and Nelson, MR and Connor, G and Chew, DP and Shiel, L and Smeath, A and de Looze, F and Steg, PG and Bhatt, DL and Liew, D, 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. ISSN 0025-729X (2012) [Refereed Article]
Copyright 2012 Australasian Medical Publishing Company
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.
|Item Type:||Refereed Article|
|Keywords:||general practice, patients, registry|
|Research Division:||Health Sciences|
|Research Group:||Health services and systems|
|Research Field:||Primary health care|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Nelson, MR (Professor Mark Nelson)|
|Web of Science® Times Cited:||13|
|Deposited By:||Menzies Institute for Medical Research|
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