Skip Navigation LinksHome > September 2010 - Volume 9 - Issue 3 > Prior Cardiovascular Interventions Are Not Associated With W...
Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine:
doi: 10.1097/HPC.0b013e3181e7f93e
Original Article

Prior Cardiovascular Interventions Are Not Associated With Worsened Clinical Outcomes in Patients With Symptomatic Atherothrombosis

Boden, William E. MD*; Cherr, Gregory S. MD†; Eagle, Kim A. MD‡; Cannon, Christopher P. MD§; Califf, Robert M. MD¶; Hirsch, Alan T. MD∥; Alberts, Mark J. MD**; Criqui, Michael MD, MPH††; Creager, Mark A. MD‡‡; Massaro, Joseph M. PhD§§; D'Agostino, Ralph B. Sr PhD¶¶; Steg, P. Gabriel MD∥∥; Bhatt, Deepak L. MD, MPH***; on behalf of the REACH Registry Investigators

Collapse Box

Abstract

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 ≥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 ≥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.

© 2010 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.