REACH Registry Demonstrates That Multiple Arterial Disease Locations Sharply Increase the Risk of Major CV Events in Outpatients With Atherothrombosis

REACH Registry Demonstrates That Multiple Arterial Disease Locations Sharply Increase the Risk of Major CV Events in Outpatients With Atherothrombosis

March 20, 2007

The Reduction of Atherothrombosis for Continued Health
(REACH)
Registry 1-Year Results

    PARIS, March 20 /Xinhua-PRNewswire/ -- The REACH
Registry 1-year results paper published today in the
Journal of the American Medical Association (JAMA) show
that outpatients with atherothrombosis have a surprisingly
high risk of death or major cardiovascular illness,
especially if more than one vascular bed is diseased. 
REACH also documented high event rates that accrued almost
linearly over time -- in contrast to the sharp rise
followed by a leveling off of event rates that is usually
seen in patients discharged from hospital after acute
events.  REACH is the first international outpatient
registry to characterize the real-world burden of
atherothrombotic disease worldwide (REACH).

    -- Within a year, around one in seven patients will
die, experience a heart attack or stroke, or be
hospitalized from a complication arising from
atherothrombosis -- clogged arteries in the heart, brain or
legs.
    -- Patients with atherothrombosis in the legs
(peripheral arterial disease: PAD) have a one in five (21%)
chance of dying, having a heart attack or stroke or being
hospitalized due to cardiovascular reasons within one
year.
    -- Over the same period of time, for patients who have
atherothrombosis in more than one area (heart, brain and/or
legs) this risk doubles.
    -- The risk increases dependent on the number of
arterial beds affected; with 5% event rate for patients
with risk factors only; 13% for patients with risk factors
and one diseased vascular bed, 22% for patients with risk
factors and two diseased vascular beds and 26% for patients
with risk factors and three diseased vascular beds
    -- REACH demonstrates that up to 1.75 million CV events
could be seen in those patients with multiple arterial
disease in the US alone over the next 12 months(X)

    For patients without a history of coronary,
cerebrovascular or PAD, but who have at least 3 risk
factors for developing these conditions (such as diabetes,
high blood pressure, high cholesterol and smoking), around
5 percent had a major event or were hospitalized within 1
year.

    "I find these event rates to be high, given that
we are dealing with a stable outpatient population treated
with contemporary therapy," said Dr Gabriel Steg,
professor of cardiology at Hopital Bichat-Claude Bernard,
Paris, on behalf of the REACH Registry's Scientific
Council. "The impact of polyvascular disease on the
risk of event in REACH shows that it is critical that we
stop viewing atherothrombosis as a disease of a specific
medical specialty -- cardiology, neurology, or vascular
disease -- instead we must view it as a 'global' disease,
Doctors' adherence to evidence-based guidelines for
treatment are important to manage the risk for this group
of patients," Dr. Steg said.

    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, having recruited
over 68,000 patients in 44 countries, covering six regions
-- Latin America, Asia, the Middle East, Australia, Europe
and North America -- and involving over 5,000 physician
investigators.

    The REACH Registry includes a broad spectrum of
patients with atherothrombosis -- documenting the health
status and treatment of people at risk of atherothrombosis;
monitoring how they are affected; and measuring the burden
of the disease. Patients included in the REACH Registry
either have several of the risk factors that can lead to
atherothrombosis, such as, high cholesterol, high blood
pressure, smoking, and diabetes, or have a previous history
of heart attack, stroke or PAD. Participation in the REACH
Registry is strictly voluntary.

    In addition, the REACH registry is based in a real-life
setting and seeks to increase overall understanding of
atherothrombotic disease across several medical
specialities (cardiology, neurology, internal medicine,
vascular medicine and office-based primary care
physicians), which allows for a more thorough assessment of
the real-world burden of the disease.

    The underlying cause of heart attack, stroke and PAD

    Atherothrombosis occurs when a blood clot (thrombus)
forms on a ruptured plaque (atheroma) in the wall of a
blood vessel. Plaques consist of fatty acids and
cholesterol, calcium and other materials.

    The rupture of plaques and the subsequent development
of a clot can cause partial or complete blockage of an
artery in various parts of the body. When a vessel in the
heart is partially or completely blocked by a clot the
result can be a heart attack. In the brain, the same
process can cause a stroke. Elsewhere in the body, this
process can lead to reduction or blockage of blood flow in
the arteries of the legs -- PAD -- a significant risk
factor for heart attack or stroke.

    Atherothrombosis is thus the common thread linking
heart attack, stroke and peripheral arterial disease.

    Notes to Editors:

    REACH Registry

    The REACH Registry is the first outpatient registry to
characterize real-world event rates and treatment patterns
in a broad spectrum of patients with atherothrombosis
worldwide. The registry follows more than 60,000 patients
over 4 years, involving 44 countries and 5,000 physician
investigators. The REACH registry aims to improve the
assessment and management of patients with a history of
coronary artery disease (CAD), cerebrovascular disease
(Stroke/TIA), peripheral arterial disease (PAD), and those
with a combination of high risk factors

    The REACH Registry is sponsored by Sanofi-Aventis,
Bristol-Myers Squibb, and the Waksman Foundation (Tokyo,
Japan), who assisted with the design and conduct of the
study and data collection.

    REACH Registry Baseline Publication:

    DL. Bhatt, PG Steg, EM.Ohman, AT.Hirsch, Y.Ikeda,
JL.Mas, S.Goto, C-S.Liau, AJ.Richard, J.Rother, PWF.Wilson,
on behalf of the REACH Registry
Investigators. International Prevalence, Recognition, and
Treatment of Cardiovascular Risk Factors in Outpatients
with Atherothrombosis. JAMA 2006;295:180-9.

    REACH Registry Scientific Council:

    -- Philippe Gabriel Steg, AP-HP, Hopital Bichat-Claude
Bernard, Paris,
       France (co-chair)
    -- Deepak L. Bhatt, Cleveland Clinic Foundation,
Cleveland, USA (co-chair)
    -- E. Magnus Ohman, Duke University, Durham, NC, USA
    -- Joachim Rother, Universitat-Klinikum Minden, Minden,
Germany
    -- Peter F. Wilson, Medical University of South
Carolina, Charleston, USA

    (X) a total of approx. 1.75 million events in the PAD
population alone (comprising, CV death, MI, stroke and
hospitalization for an atherothrombotic event)


    For more information, please contact: 

     Anna Gray
     REACH Registry Editorial Support Group, During ACC: 
     Tel:    [phone]
     Office: [phone]

     Professeur Philippe Gabriel Steg
     Departement de Cardiologie Hopital Bichat-Claude
Bernard Assistance 
      Publique
     Hopitaux de Paris
     Office: [phone]
     Cell:   [phone]
     Fax:    [phone]
     Email:  [e-mail]/
     Web:    http://www.REACHregistry.org /