Related Experiment Video
Updated: Jul 6, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Risk factor profile and management of cerebrovascular patients in the REACH Registry
Joachim Röther1, Mark J Alberts, Emmanuel Touzé
1Department of Neurology, Klinikum Minden, Hannover Medical School, Minden, Germany. joachim.roether@klinikum-minden.de
Insights
Cerebrovascular disease patients often have other conditions, increasing their risk for future events. Many patients are undertreated, highlighting a need for better adherence to medical guidelines.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Cerebrovascular disease (CVD) is a significant global health concern.
- CVD patients face a high risk of recurrent stroke and other atherothrombotic events.
- Risk factors, comorbidities, and secondary prevention significantly impact recurrent event rates.
Purpose of the Study:
- To assess risk factors, comorbidities, and secondary prevention in a large cohort of cerebrovascular disease patients.
- To evaluate the utilization and adherence to secondary prevention therapies in stable outpatients with CVD.
- To understand factors influencing recurrent atherothrombotic events in a global patient registry.
Main Methods:
- Analysis of data from the Reduction of Atherothrombosis for Continued Health (REACH) Registry, including over 68,000 outpatients from 44 countries.
- Focus on 18,992 patients with symptomatic cerebrovascular disease (CVD).
- Inclusion criteria involved symptomatic CVD, coronary artery disease, peripheral arterial disease (PAD), and/or at least three atherothrombotic risk factors.
Main Results:
- The study population included patients with stroke (53.7%), transient ischemic attack (TIA) (27.7%), or both (18.5%).
- 40% of CVD patients had symptomatic disease in at least one additional vascular bed (e.g., coronary artery disease, PAD).
- Higher prevalence of risk factors like hypertension, obesity, hypercholesterolemia, atrial fibrillation, and carotid artery disease was observed in the TIA subgroup compared to the stroke group. Guideline treatment targets were frequently unmet.
Conclusions:
- A substantial proportion of cerebrovascular disease patients exhibit additional atherothrombotic disease manifestations.
- The identified risk profiles, particularly in the TIA subgroup, indicate a high risk for future atherothrombotic events.
- Undertreatment is prevalent globally, emphasizing the critical need for improved adherence to established medical guidelines for CVD management.
Background:
Cerebrovascular disease (CVD) is a global public health problem. CVD patients are at high risk of recurrent stroke and other atherothrombotic events. Prevalence of risk factors, comorbidities, utilization of secondary prevention therapies and adherence to guidelines all influence the recurrent event rate. We assessed these factors in 18,992 CVD patients within a worldwide registry of stable outpatients.
Methods:
The Reduction of Atherothrombosis for Continued Health Registry recruited >68,000 outpatients (44 countries). The subjects were mainly recruited by general practitioners (44%) and internists (29%) if they had symptomatic CVD, coronary artery disease, peripheral arterial disease (PAD) and/or >or=3 atherothrombotic risk factors.
Results:
The 18,992 CVD patients suffered a stroke (53.7%), transient ischemic attack (TIA) (27.7%) or both (18.5%); 40% had symptomatic atherothrombotic disease in >or=1 additional vascular beds: 36% coronary artery disease; 10% PAD and 6% both. The prevalence of risk factors at baseline was higher in the TIA subgroup than in the stroke group: treated hypertension (83.5/82.0%; p = 0.02), body mass index >or=30 (26.7/20.8%; p < 0.0001), hypercholesterolemia (65.1/52.1%; p < 0.0001), atrial fibrillation (14.7/11.9%; p < 0.0001) and carotid artery disease (42.3/29.7%; p < 0.0001). CVD patients received antiplatelet agents (81.7%), oral anticoagulants (17.3%), lipid-lowering agents (61.2%) and antihypertensives (87.9%), but guideline treatment targets were frequently not achieved (54.5% had elevated blood pressure at baseline, while 4.5% had untreated diabetes).
Conclusions:
A high percentage of CVD patients have additional atherothrombotic disease manifestations. The risk profile puts CVD patients, especially the TIA subgroup, at high risk for future atherothrombotic events. Undertreatment is common worldwide and adherence to guidelines needs to be enforced.
Related Concept Videos
01:26Atherosclerosis III: Management
01:26Coronary Artery Disease IV: Preventive Measures
01:15Ischemic Stroke l: Introduction
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
01:17Hemorrhagic Stroke l: Introduction
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...