Objectives We sought to assess the risk profile, management and subsequent 1-year cardiovascular (CV) event rates in Chinese patients who had a history of established atherosclerotic arterial disease, including coronary artery disease (CAD), stroke, peripheral vascular disease (PAD), or with two or more cardiovascular risks.
Methods From Oct. 2004 to Jan. 2005, 3732 Chinese patients with either atherosclerotic arterial disease (CAD, stroke, PAD; n = 2689) or at least 2 risk factors for atherothrombosis (n = 734) were sequentially enrolled in the study. Outcomes of interest included CV death, myocardial infarction (MI), stroke and hospitalisation for atherothrombotic events.
Results During a mean follow-up time of 13.6 ± 1.5 months, 309 participants (8.3%) were lost. Overall, the all cause death rate was 8.6% (294 deaths), with CV deaths accounting for 41.2% (121 deaths; 3.5% overall). CV death was 4.4% for those with atherosclerotic arterial disease vs 1.1% for patients with multiple risk factors only. Among patients with established disease, CV death was 4.2% for patients with CAD, 5.0% for patients with stroke, and 6.3% for patients with PAD. For the end point of CV death/MI/stroke/hospitalisation for atherothrombotic events, the highest event rate occurred among patients with 3 vascular disease locations (34.3%), followed by those with 2 (27.6%), 1 location (21.0%) and those with risk factors only (12.7%, P < 0.001). A large percentage of patients did not reach the therapeutic target values specified in current guidelines.
Conclusions In Chinese patients with established atherosclerotic arterial disease, or at risk of atherothrombosis, a substantial increase in cardiovascular event rates with increasing numbers of affected arterial beds. PAD patients appeared to be at an especially high risk. Our study suggests a need to improve detection and consequent medical treatment of multi-site atherosclerotic arterial disease.