Cardiovascular event rates in patients with cerebrovascular disease and atherothrombosis at other vascular locations: Results from 1-year outcomes in the Japanese REACH Registry

Uchiyama, Shinichiro; Goto, Shinya; Matsumoto, Masayasu; Nagai, Ryozo; Origasa, Hideki; Yamazaki, Tsutomu; Shigematsu, Hiroshi; Shimada, Kazuyuki; Yamada, Nobuhiro; Bhatt, Deepak L.; Steg, P. Gabriel; Ikeda, Yasuo; on behalf of the REACH Registry Investigators,

doi:10.1016/j.jns.2009.09.011

« Previous Next »Journal of the Neurological Sciences
Volume 287, Issue 1 , Pages 45-51, 15 December 2009

Cardiovascular event rates in patients with cerebrovascular disease and atherothrombosis at other vascular locations: Results from 1-year outcomes in the Japanese REACH Registry

Shinichiro Uchiyama
- Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
- Corresponding author. Department of Neurology, Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. Tel.: +81 3 3353 8111; fax: +81 3 3341 0613.
Shinya Goto
- Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan
Masayasu Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
Ryozo Nagai
- Department of Cardiology, University of Tokyo, Tokyo, Japan
Hideki Origasa
- Division of Biostatistics and Clinical Epidemiology, University of Toyama, Toyama, Japan
Tsutomu Yamazaki
- Department of Pharmacoepidemiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Hiroshi Shigematsu
- Department of Vascular Surgery, Tokyo Medical University, Tokyo, Japan
Kazuyuki Shimada
- Department of Cardiology, Jichi Medical University, Tochigi, Japan
Nobuhiro Yamada
- Department of Metabolism and Endocrinology, University of Tsukuba, Ibaraki, Japan
Deepak L. Bhatt
- VA Boston Healthcare System and Brigham and Women's Hospital, Boston, USA
P. Gabriel Steg
- INSERM U-698, Université Paris 7 and Assistance Publique, Hôpitaux de Paris, Paris, France
Yasuo Ikeda
- Department of Medicine, Keio University School of Medicine, Tokyo, Japan
on behalf of the REACH Registry Investigators

Received 12 March 2009; received in revised form 13 August 2009; accepted 10 September 2009. published online 08 October 2009.

Abstract

The REduction of Atherothrombosis for Continued Health (REACH) Registry is a large, international, prospective cohort of patients with atherothrombosis or multiple (≥3) risk factors (MRFs) for atherothrombosis.

Japanese patients (n=5193) were enrolled into the REACH registry between August and December 2004. One-year event rate in patients with cerebrovascular disease (CVD) was compared with that of patients with symptomatic atherothrombosis at other locations.

After one year (n=5021), patients with CVD (n=1962) experienced a higher rate of non-fatal strokes than patients with coronary artery disease (CAD), peripheral artery disease (PAD) or MRFs alone (2.77% vs. 1.28%, 2.07% and 1.56%, respectively), but a lower rate of non-fatal myocardial infarction (0.45% vs. 1.31%, 0.77% and 0.66%, respectively). Patients with CVD plus disease in ≥1 other vascular bed had higher rates of cardiovascular events than patients with CVD alone. Overall, event rates including non-fatal stroke, non-fatal myocardial infarction and cardiovascular death were higher for patients with CVD and PAD than for patients with CVD and CAD. Asymptomatic carotid stenosis ≥70% and ankle-brachial index <0.9 were significant predisposing factors for stroke.

Patients with CVD and co-existing atherothrombotic diseases had a high risk of recurrent events, including events arising in other vascular beds than originally diagnosed.

Keywords: Atherothrombosis, Cerebrovascular disease, Coronary artery disease, Epidemiology, Japan, Peripheral artery disease