Identifying international differences in outcomes among patients with atherothrombotic disease may enhance strategies for risk reduction and prevention

World Congress of Cardiology Report - The Reduction of Atherothrombosis for Continued Health (REACH) Registry investigators have released preliminary two-year outcomes data from this international, observational study which shows high rates of atherothrombotic events (such as heart attacks and strokes) on a worldwide basis.

The data also demonstrates significant regional variation in the distribution of these events, with Eastern Europe and Middle East faring particularly badly. The findings emphasize the fact that there is a need for global efforts to reduce the increasing burden of atherothrombotic disease, both in those who have already had an event and those considered at high risk for a first event. Compared with global event rates at one year, the two-year event rates in patients with established atherothrombotic disease have approximately doubled, and in those with no previous history of disease, but with a combination of risk factors, the increase appears to be higher.

Over 68,000 patients in 44 countries have been recruited into the REACH Registry. Eligible patients enrolled were aged ¡Ý45 with at least one of the following four criteria: documented coronary artery disease (such as previous heart attack or bypass surgery, stable angina), peripheral arterial disease (blockages in the arteries outside the heart or brain), cerebrovascular disease (such as stroke), or with any combination of at least three atherosclerotic risk factors such as diabetes, high blood pressure, high cholesterol, smoking, and older age (¡Ý65 males, ¡Ý70 females).

"Cardiac and vascular atherothrombotic disease has recently been recognized as the leading cause of death worldwide, however this has been explored in few contemporary global registries," according to E. Magnus Ohman, MD, Professor of Medicine at Duke University Medical Center. ¡°We sought to compare worldwide atherothrombotic event rates in at-risk and secondary prevention populations.

"The REACH Registry has identified significantly high and worldwide differences in the burden of atherothrombotic events during a two-year period. Patients in regions like the Middle East and Eastern Europe experience higher event rates compared with the rest of the world. Global efforts are urgently needed to impact the burden of disease in both secondary prevention and at-risk populations with special emphasis on regions where event rates remain high," Ohman and colleagues concluded.

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, recruiting 68,000 patients in 44 countries, covering seven regions - Latin America, Asia, the Middle East, Australia, Western Europe, Eastern Europe and North America - and involving over 5,000 physician investigators. Annual follow-up of patients has recently been extended to 4 years.