Atherothrombosis: a higher rate of cardiovascular events

Outpatients with atherothrombosis have a surprisingly high rate of cardiovascular death or serious cardiac events such as myocardial infarction or stroke (stroke), according to the one-year results of the REACH registry, presented at the annual meeting of the American College of Cardiology, which s is held in Atlanta (USA).

Risk factors should not be overlooked

The purpose of this registry is to study the characteristics of patients, how they are treated, the extent of damage and the impact of atherothrombotic disease worldwide on the fate of people. He has recruited in 2004 68.000 patients in 44 countries covering six regions: Latin America, North America, Australia, Asia, Europe, Middle East.

After a year of monitoring, approximately one in eight patients on average will either die or suffer a heart attack or stroke, or hospitalization for a complication related to atherothrombosis (clogged arteries of the heart, brain or legs ) and the risk appears even greater for patients with multiple vascular locations.

Overall, the researchers found a serious cardiovascular event rate of 13% after one year of follow-up. It is mainly patients with peripheral arterial that have a substantially higher risk with a rate after a year of events by 22%. In addition, there has been a steady increase in risk in patients with multiple vascular locations, the event rate from 13% for a single patient vascular territory at 28% for three vascular sites affected.

For patients without a history of coronary artery disease, cerebrovascular or peripheral arterial disease, but with at least three risk factors for developing these diseases (such as diabetes, hypertension, high cholesterol or smoking), about 5% had a serious event or were hospitalized for a cardiovascular cause after one year of follow-up.

In the opinion of Dr. Gabriel Steg (CHU Bichat-Claude Bernard, Paris), co-chairman of the Scientific Council of the REACH registry, "these event rates are particularly high, especially if one considers that it is a population of stable and treated with modern therapeutic "outpatients.

"The REACH data show that it is essential to stop seeing atherothrombosis as a disease of each specialist (cardiologist, neurologist, angiologist) to the now considered as a whole," he says.

Originally clot

Atherothrombosis occurs when a blood clot (thrombus) forms on an atherosclerotic plaque ruptured in an artery wall. The plates are made from cholesterol and fatty acids, calcium and other substances.

Plaque rupture and secondary appearance at the site of the rupture of a blood clot can cause partial or complete blockage of an artery in various parts of the body.

When a vessel of the heart is partially or completely occluded by a blood clot, the result can be a heart attack. In the brain, the same process can cause a stroke. Elsewhere in the body, it is responsible for a reduction or occlusion of the arteries of the legs (peripheral arterial disease), which is associated with elevated myocardial infarction and stroke risk.

Atherothrombosis is the thread that connects infarction, stroke and peripheral arterial disease, said Dr. Steg.