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

- The Reduction of Atherothrombosis for Continued Health (REACH)

- Registry 1-Year Results

PARIS, March 20, 2007 /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, Britsol-Myers Squibb, and the Waksman Foundation (Tokyo, Japan), who assisted with the design and conduct of the study an d 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 I the PAD population alone (comprising, CV death, MI, stroke and hospitalization for an atherothrombotic event)

For further information on the REACH Registry please visit www.REACHRegistry.org

CONTACT: Contact Details: Anna Gray, REACH Registry Editorial SupportGroup, Tel: (during ACC): +44-7816-280576, Office: +44-(0)-207-300-6281;Professeur Philippe Gabriel STEG, MD, FESC, FACC, FACCP, Departement deCardiologie, Hopital Bichat-Claude Bernard, Assistance Publique - Hopitauxde Paris, 46 rue Henri Huchard, 75018 Paris, France, Tel:+33-(0)-1-40-25-86-68, Cell: +33-(0)-6-07-24-62-24, Fax:+33-(0)-1-40-25-88-65, e-mail: gabriel.steg@bch.aphp.fr

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