Prior cardiovascular interventions are not associated with worsened clinical outcomes in patients with symptomatic atherothrombosis.

Published

Journal Article

To assess the effect of prior cardiovascular interventions on long-term clinical outcomes in patients with symptomatic atherothrombosis, the risk factor profiles, treatment patterns, and 24-month outcomes of patients in the United States with and without prior cardiovascular intervention (catheter-based, surgical, or lower-limb amputation) enrolled in the global REACH (REduction of Atherothrombosis for Continued Health) Registry were compared. Of the 17,521 US outpatients aged > or =45 years with established coronary artery disease, cerebrovascular disease, or peripheral artery disease enrolled in the REACH Registry between December 1, 2003 and June 1, 2004 who had > or =1 follow-up visit, 11,925 (68.1%) had a previous cardiovascular intervention. Prior intervention was most common in patients with coronary artery disease (76.7%) and least common in patients with cerebrovascular disease (14.6%) at baseline. Patients with prior cardiovascular intervention were significantly more likely to be taking antihypertensive, antithrombotic, or lipid-lowering therapies than those without prior intervention (P < 0.0001 for each therapy). However, 24-month Kaplan-Meier event rates for the composite outcome of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke were similar between patients with and without prior intervention (9.10% vs. 9.00%; P = 0.49). Thus, in the US REACH Registry, prior cardiovascular intervention was not associated with an increased risk of subsequent cardiovascular ischemic events during follow-up. Patients without prior cardiovascular intervention had a lower intensity of risk factor modification at baseline and appear to represent an at-risk, undertreated population.

Full Text

Duke Authors

Cited Authors

  • Boden, WE; Cherr, GS; Eagle, KA; Cannon, CP; Califf, RM; Hirsch, AT; Alberts, MJ; Criqui, M; Creager, MA; Massaro, JM; D'Agostino, RB; Steg, PG; Bhatt, DL; REACH Registry Investigators,

Published Date

  • September 2010

Published In

Volume / Issue

  • 9 / 3

Start / End Page

  • 116 - 125

PubMed ID

  • 20802264

Pubmed Central ID

  • 20802264

Electronic International Standard Serial Number (EISSN)

  • 1535-2811

Digital Object Identifier (DOI)

  • 10.1097/HPC.0b013e3181e7f93e

Language

  • eng

Conference Location

  • United States