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High cardiovascular event rates in patients with asymptomatic carotid stenosis: the REACH Registry

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • F T Aichner
  • R Topakian
  • M J Alberts
  • D L Bhatt
  • H-P Haring
  • M D Hill
  • G Montalescot
  • S Goto
  • E Touzé
  • J-L Mas
  • P G Steg
  • J Röther
  • Iversen, Helle Klingenberg
  • REACH Registry Investigators
BACKGROUND AND PURPOSE: Data on current cardiovascular event rates in patients with asymptomatic carotid artery stenosis (ACAS) are sparse. We compared the 1-year outcomes of patients with ACAS > or =70% versus patients without ACAS in an international, prospective cohort of outpatients with or at risk of atherothrombosis. METHODS: The Reduction of Atherothrombosis for Continued Health Registry enrolled patients with either > or =3 atherothrombotic risk factors or established atherothrombotic disease. We investigated the 1-year follow-up data of patients for whom physicians reported presence/absence of ACAS at the time of inclusion. RESULTS: Compared with patients without ACAS (n = 30 329), patients with ACAS (n = 3164) had higher age- and sex-adjusted 1-year rates of transient ischaemic attack (3.51% vs. 1.61%, P <0.0001), non-fatal stroke (2.65% vs. 1.75%, P = 0.0009), fatal stroke (0.49% vs. 0.26%, P = 0.04), cardiovascular death (2.29% vs. 1.52%, P = 0.002), the composite end-point cardiovascular death/myocardial infarction/stroke (6.03% vs. 4.29%, P <0.0001) and bleeding events (1.41% vs. 0.81%, P = 0.002). In patients with ACAS, Cox regression analyses identified history of cerebrovascular ischaemic events as most important predictor of future stroke (HR 3.21, 95% CI 1.82-5.65, P <0.0001). CONCLUSION: Asymptomatic carotid artery stenosis was associated with high 1-year rates of cardiovascular and cerebrovascular ischaemic events. Stroke was powerfully predicted by prior cerebrovascular ischaemic events.
OriginalsprogEngelsk
TidsskriftEuropean Journal of Neurology
Vol/bind16
Udgave nummer8
Sider (fra-til)902-8
Antal sider7
ISSN1351-5101
DOI
StatusUdgivet - 1 aug. 2009

ID: 34163875