Outpatients with stable atherothrombosis have a surprisingly high risk of death or major cardiovascular event, according to new one-year data from the international REACH registry presented at the annual meeting of the American College of Cardiology.

Overall, investigators observed a major adverse cardiovascular event rate of 13 percent at one year. Strikingly however, patients with peripheral arterial disease were at substantially higher risk, with a one-year rate of 22 percent. In addition, there was a stepwise increase in risk in people with widespread atherothrombotic disease. In patients with atherothrombotic disease in one location only, the major adverse event rate was 13 percent, whereas in those with disease in three locations, the risk climbed to 28 percent.

For patients without a history of coronary, cerebrovascular, or peripheral arterial disease, but who had at least three risk factors, such as diabetes, hypertension, high cholesterol, and smoking, roughly 5 percent had a major event or were hospitalized within one 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 REACH data 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."

The overall aim of the REACH registry is to improve the assessment and management of stroke, myocardial infarction, and associated risk factors for atherothrombosis. It is the largest and most geographically extensive global registry of patients at risk of atherothrombosis, with 68,000 patients in 44 countries, covering six regions - Latin America, Asia, the Middle East, Australia, Europe and North America.