Cardiovascular risk factor control and outcomes in peripheral artery disease patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry

Atherosclerosis. 2009 Jun;204(2):e86-92. doi: 10.1016/j.atherosclerosis.2008.10.023. Epub 2008 Oct 31.

Abstract

Objectives: To examine differences in risk factor (RF) management between peripheral artery disease (PAD) and coronary artery (CAD) or cerebrovascular disease (CVD), as well as the impact of RF control on major 1-year cardiovascular (CV) event rates.

Methods: The REACH Registry recruited >68000 outpatients aged >or=45 years with established atherothrombotic disease or >or=3 RFs for atherothrombosis. The predictors of RF control that were evaluated included: (1) patient demographics, (2) mode of PAD diagnosis, and (3) concomitant CAD and/or CVD.

Results: RF control was less frequent in patients with PAD (n=8322), compared with those with CAD or CVD (but no PAD, n=47492) [blood pressure; glycemia; total cholesterol; smoking cessation (each P<0.001)]. Factors independently associated with optimal RF control in patients with PAD were male gender (OR=1.9); residence in North America (OR=3.5), Japan (OR=2.5) or Latin America (OR=1.5); previous coronary revascularization (OR=1.3); and statin use (OR=1.4); whereas prior leg amputation was a negative predictor (OR=0.7) (P<0.001). Optimal RF control was associated with fewer 1-year CV ischemic symptoms or events.

Conclusions: Patients with PAD do not achieve RF control as frequently as individuals with CAD or CVD. Improved RF control is associated with a positive impact on 1-year CV event rates.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Atherosclerosis / complications
  • Atherosclerosis / therapy*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / therapy
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Peripheral Vascular Diseases / complications
  • Peripheral Vascular Diseases / therapy*
  • Proportional Hazards Models
  • Prospective Studies
  • Registries
  • Risk Assessment
  • Risk Factors
  • Thrombosis / complications
  • Thrombosis / therapy*
  • Time Factors