Clinical descriptors can assist clinicians in identifying patients with various stages of atherothrombosis (abnormal fatty deposits in an artery) who are at high-risk of future cardiovascular events, according to a study that will appear in the September 22 issue of JAMA. The study is being released early online to coincide with its presentation at the European Society of Cardiology meeting in Stockholm.
"Patients with atherothrombosis are at elevated risk of ischemic events [such as heart attack or stroke] but, depending on their specific manifestations of atherothrombosis, may have varying degrees of future risk for ischemic events," the authors write as background in the article. "For clinicians, the ability to identify rapidly the major determinants of risk among patients with atherosclerosis would be useful to triage novel preventive therapies toward those at the higher end of the spectrum."
Deepak L. Bhatt, M.D., M.P.H., of the VA Boston Healthcare System, Brigham and Women's Hospital and Harvard Medical School, Boston, and colleagues studied 45,227 patients who were enrolled in the global Reduction of Atherothrombosis for Continued Health (REACH) study. Detailed information was gathered at baseline, with additional annual follow-up at one, two, three and four years. Patients were enrolled between 2003 and 2004 and follow-up continued until 2008. Hypertension and hypercholesterolemia (high cholesterol levels in the blood) were common, present in 81.3 percent and 70.4 percent of patients, respectively. Additionally, polyvascular disease (atherosclerotic disease in multiple arterial territories) was present in 15.9 percent of patients and 48.4 percent had prior ischemic events, with 28.1 percent of those having an ischemic event within the previous year.