Despite improved PAD awareness, treatment and diagnosis during the past five years, Hirsch and investigators hypothesized that cardiovascular disease event rates would remain high, and that complacency in treating this disease was not merited. The analysis of international individuals enrolled in REACH found this to be true. All individuals with PAD, regardless of symptom status or past use of leg angioplasty or leg bypass remained at high risk.
"The REACH Registry continues to demonstrate the real-world burden of atherothrombotic disease worldwide. In the case of PAD, further analysis has re-emphasized the need for doctors to adhere to evidence-based guidelines for treatment like long-term antiplatelet therapy with aspirin or clopidogrel," said Dr. Gabriel Steg, professor of cardiology at Hopital Bichat-Claude Bernard, Paris, on behalf of the REACH Registry's Scientific Council. "But first diagnosis must happen earlier and to do this the tools need to be more readily available and reimbursed, especially in Europe."
Details on Hirsch Analysis
Results: REACH enrolled 8581 individuals with PAD, by asymptomatic ABI<0.9 alone (8%); claudication (65%); prior limb revascularization (50%); or amputation (13%). Risk factors were prevalent (diabetes 44%, current smoking 24%, hypercholesterolemia 66%). Antiplatelet (81%), antihypertensive (87%), antidiabetic (40%), and lipid-lowering therapies (70%) were well-utilized. Non-fatal CV disease events and mortality remained high (Table). Leg angioplasty, vascular bypass, or amputation occurred at annual rates of 7.6%, 5.3%, and 2.8%, respectively.
In addition to the analysis on PAD, REACH investigators presented posters on other sub-analyses during the European Society of Cardiology Congress 2007:
-- "Cardiovascular events of Asian pati
|SOURCE REACH Registry|
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