Influence of polyvascular disease on cardiovascular event rates. Insights from the REACH Registry
Open accessAbstract
Cardiovascular event rates have been shown to increase substantially with the number of symptomatic disease locations. We sought to assess the risk profile, management and subsequent event rates of polyvascular disease patients. Consecutive outpatients were assessed for atherosclerotic risk factors and medications in the REACH Registry. A total of 19,117 symptomatic patients in Europe completed a 2-year follow-up: 77.2% with single arterial bed disease (coronary artery or cerebrovascular or peripheral arterial disease) and 22.8% with polyvascular disease (≥ 1 disease location). Polyvascular disease patients were older (68.5 ± 9.4 vs 66.3 ± 9.9 years, p < 0.0001), more often current or former smokers (64.9% vs 58.7%, p < 0.0001), and more often suffered from hypertension (59.5% vs 46.6%, p < 0.0001) and diabetes (34.5% vs 25.9%, p < 0.0001) than single arterial bed disease patients. Despite more intense medical therapy, risk factors (smoking, hypertension, low fasting glucose, and low fasting total cholesterol) were less often controlled in polyvascular disease patients. This was associated with substantially more events over 2 years compared with single arterial bed disease patients (cMACCE [cardiovascular death/non-fatal stroke/non-fatal MI] odds ratio, 1.63 [95% CI, 1.45—1.83], p < 0.0001). In conclusion, polyvascular disease patients have more cardiovascular risk factors, and the prognosis for these patients is significantly worse than for patients with single arterial bed disease. This suggests a need to improve detection and consequent medical treatment of polyvascular disease.
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When peripheral artery disease or cerebrovascular disease is concurrent with acute coronary syndrome, risk may be particularly elevated.
“When PAD or CeVD is concurrent with ACS, risk may be particularly elevated, warranting more intensive approaches to secondary prevention (5,6).”
From Alirocumab in Patients With Polyvascular Disease and Recent Acute Coronary Syndrome (2019) · cites this paper as [5]
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- Authors
- Suárez, C., Zeymer, U., Limbourg, T., Baumgartner, I., Cacoub, P., Poldermans, D., Röther, J., Bhatt, D. L., Steg, P. G., & REACH Registry Investigatorsa
- Affiliations
- Hospital Universitario de La Princesa (ES)
- Heidelberg University (DE)
- Swiss Cardiovascular Centre, Division of Clinical and Interventional Angiology, Inselspital, University Hospital, Berne, Switzerland
- Assistance Publique – Hôpitaux de Paris (FR)
- Erasmus MC (NL)
- Medizinische Hochschule Hannover (DE)
- Brigham and Women's Hospital (US)
- INSERM U-698, Université Paris 7 and AP-HP, Paris, France
- Venue
- Vascular Medicine
- Publisher
- SAGE Publications
- Published
- 2010-08
- Volume
- 15
- Issue
- 4
- Pages
- 259-265
- ISSN
- 1358-863X (ISSN-L)
- 1477-0377
- OpenAlex
- W2169002626
- Cited by
- 106
- References
- 25
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 13 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 10 · 2019: 13 · 2018: 6 · 2017: 9 · 2016: 3 · 2015: 2 · 2014: 4 · 2013: 2 · 2012: 4
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Vascular Medicine (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- DIAL (Catholic University of Leuven) (submittedVersion)
- Lithuanian University of Health Sciences (submittedVersion)
- Funders
- Bristol-Myers Squibb
- Sanofi
- Inselspital, Universitätsspital Bern
- Erasmus Medisch Centrum
- Centre Hospitalier Universitaire Vaudois
- Debreceni Egyetem
- World Heart Federation
- University of Ioannina
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- polyvascular disease, cardiovascular events, coronary artery disease, cerebrovascular disease, peripheral arterial disease, major adverse cardiovascular events, cardiovascular risk factors, smoking, hypertension, diabetes mellitus, lipid control, REACH registry, prognosis
- MeSH terms
- Aged, Coronary Artery Disease, Europe, Female, Follow-Up Studies, Humans, Male, Middle Aged, Registries, Risk Factors, Severity of Illness Index, Thrombosis, Vascular Diseases, Comorbidity, Peripheral Vascular Diseases, Atherosclerosis
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