Risk Factors and Event Rates in Patients With Atherothrombotic Disease in Germany: Results of the REACH Registry.

Introduction: The aim of the international Reduction of Atherothrombosis for Continued Health (REACH) registry was to identify prospectively characteristics, risk factors, treatments, and cardiovascular event rates in stable outpatients with atherothrombotic disease, as well as in asymptomatic patients with risk factors for atherothrombotic disease.

Methods: A total of 512 physicians in Germany enrolled 4986 outpatients with documented atherothrombotic disease, as well as 608 asymptomatic patients with at least three risk factors for atherothrombotic disease, in the REACH registry. Patients will be followed for up to four years, with assessments being performed at regular intervals; the results of the one-year follow-up are presented here.

Results: The documented risk factors were hypertension (58.2%), hypercholesterolemia (74.6%), diabetes (37.6%), and obesity (28.1%). A large percentage of patients did not reach the therapeutic target values specified in current German and European S1 guidelines. After 1 year, 2.1% of the patients with symptomatic atherothrombotic disease and 1.5% of the patients with at least three cardiovascular risk factors had died of a cardiovascular event, whereas 5.8% of the former and 2.5% of the latter patient group had reached a combined endpoint consisting of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.

Conclusion: The traditional risk factors are common in patients with coronary heart disease, cerebrovascular disease (stroke and/or transient ischemic attack), or peripheral arterial occlusive disease. Many patients with these conditions or associated risk factors are not treated according to current guidelines. This may explain, at least in part, the high rates of cardiovascular events observed after one year.