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[Implications of the REACH registry for neurologists]
1Hospital del Mar-IMIM, Barcelona, España. jroquer@hospitaldelmar.cat
Insights
Patients with arteriosclerotic disease face poor prognosis, with higher risks of recurrence and death. Improved management of vascular risk factors like hypertension and diabetes is crucial for better outcomes.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Epidemiology
Context:
- The REACH registry provides insights into arteriosclerotic disease.
- Arteriosclerotic burden, measured by diseased vascular territories, indicates poor prognosis.
- Patients with cerebrovascular disease, particularly stroke survivors, exhibit high rates of adverse cardiovascular events.
Purpose:
- To analyze the prognostic implications of arteriosclerotic burden.
- To identify high-risk patient groups, including those with transient ischemic attacks.
- To evaluate the current management of vascular risk factors in arteriosclerotic disease.
Summary:
- Quantifying diseased vascular territories is a significant marker for poor prognosis in arteriosclerotic disease.
- Stroke patients demonstrate the highest risk of cerebral reinfarction and combined cardiovascular events.
- Transient ischemic attack patients often have multiple accumulated vascular risk factors.
Impact:
- Findings suggest a need for intensified preventive strategies and better control of hypertension, diabetes, and hypercholesterolemia.
- Improved lifestyle habits, medication adherence, and drug management are essential for high-risk patients.
- Enhanced risk factor control can potentially reduce recurrence, morbidity, and mortality in arteriosclerotic disease.
Abstract:
Data from the REACH registry help to understand distinct problems affecting patients with arteriosclerotic disease. The arteriosclerotic burden evaluated by quantifying the number of diseased vascular territories is a marker of poor prognosis that increases the risk of recurrences, morbidity and mortality and death at 1 year. In cerebrovascular disease, it is important to highlight that patients with stroke are those with the highest rates of cerebral reinfarction and also show the highest combined rate of cardiovascular death or non-fatal myocardial infarction or stroke. Special care must be taken in patients who have had a transient ischemic attack since these patients accumulate a number of vascular risk factors. Data from the REACH registry suggest that preventive treatment and control of vascular risk factors could be improved, especially control of hypertension, diabetes and hypercholesterolemia. Consequently, preventive measures should be intensified in these patients to achieve adequate control of risk factors through encouraging healthy lifestyle habits, appropriate use of drugs and treatment adherence.
