Predicting cardiovascular risk in patients with known or suspected atherothrombosis

January 01, 0001

Predicting cardiovascular risk in patients with known or suspected atherothrombosis

Predicting which patients are at greatest cardiovascular risk can be a challenge. This international research group categorized the cardiovascular risk in stable outpatients with various known or risk factors for atheromthrombosis. Patients from 3647 centers in 29 countries were enrolled (n=45 227) in the Reduction of Atherothrombosis for Continued Health (REACH) Registry and were followed for as long as 4 years. Primary outcomes were rates of cardiovascular death, myocardial infarction, and stroke.

The researchers found: "A total of 45,227 patients with baseline data were included in this 4-year analysis. During the follow-up period, a total of 5481 patients experienced at least 1 event, including 2315 with cardiovascular death, 1228 with myocardial infarction, 1898 with stroke, and 40 with both a myocardial infarction and stroke on the same day. Among patients with atherothrombosis, those with a prior history of ischemic events at baseline (n = 21 890) had the highest rate of subsequent ischemic events (18.3%), patients with stable coronary, cerebrovascular, or peripheral artery disease (n = 15 264) had a lower risk (12.2%), and patients without established atherothrombosis but with risk factors only (n = 8073) had the lowest risk (9.1%). In addition, in multivariable modeling, the presence of diabetes (hazard ratio [HR

The researchers concluded: "Clinical descriptors can assist clinicians in identifying high-risk patients within the broad range of risk for outpatients with atherothrombosis."

While there were no big surprises in the data, this study provides important information to help quantify cardiovascular risk in patients.

For the full abstract, click here.

JAMA 304(12): 1350-1357, 22 September 2010, © 2010 American Medical Association
Comparative Determinants of 4-Year Cardiovascular Event Rates in Stable Outpatients at Risk of or With Atherothrombosis. Deepak L. Bhatt, Kim A. Eagle,E. Magnus Ohman, et al.

Category: K. Circulatory. Keywords: cardiovascular risk, atherothrombi, myocardial infarction, stroke, REACH, prospective observational study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 15 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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