Cardiovascular risk factor control and outcomes in peripheral artery disease patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry

Abstract

Objectives To examine differences in risk factor (RF) management between peripheral artery disease (PAD) and coronary artery (CAD) or cerebrovascular disease (CVD), as well as the impact of RF control on major 1-year cardiovascular (CV) event rates. Methods The REACH Registry recruited >68000 outpatients aged ≥45 years with established atherothrombotic disease or ≥3 RFs for atherothrombosis. The predictors of RF control that were evaluated included: (1) patient demographics, (2) mode of PAD diagnosis, and (3) concomitant CAD and/or CVD. Results RF control was less frequent in patients with PAD ( n = 8322), compared with those with CAD or CVD (but no PAD, n = 47492) [blood pressure; glycemia; total cholesterol; smoking cessation (each P < 0.001)]. Factors independently associated with optimal RF control in patients with PAD were male gender (OR = 1.9); residence in North America (OR = 3.5), Japan (OR = 2.5) or Latin America (OR = 1.5); previous coronary revascularization (OR = 1.3); and statin use (OR = 1.4); whereas prior leg amputation was a negative predictor (OR = 0.7) ( P < 0.001). Optimal RF control was associated with fewer 1-year CV ischemic symptoms or events. Conclusions Patients with PAD do not achieve RF control as frequently as individuals with CAD or CVD. Improved RF control is associated with a positive impact on 1-year CV event rates.