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Geographic differences in outcomes in outpatients with established atherothrombotic disease: results from the REACH

G Ducrocq1, D L Bhatt2, J Labreuche3

  • 1Université Paris-Diderot, Sorbonne Paris Cité, France; AP-HP, Hopital Bichat - Paris, France; INSERM U-698, France gregory.ducrocq@bch.aphp.fr.

European Journal of Preventive Cardiology
|August 23, 2013
PubMed

Insights

Geographical region significantly impacts outcomes for patients with atherothrombotic diseases like coronary artery disease (CAD), cerebrovascular disease (CVD), and peripheral artery disease (PAD). Outcomes varied, with Japan and Western Europe showing lower risks compared to Eastern Europe.

Area of Science:

  • Cardiovascular Medicine
  • Epidemiology
  • Public Health

Background:

  • Atherothrombotic diseases (CAD, CVD, PAD) exhibit varying prevalence and management globally.
  • Limited data exists for cross-regional comparisons of management and outcomes in these patients.

Purpose of the Study:

  • To investigate geographical disparities in baseline characteristics, management strategies, and 4-year outcomes for stable outpatients with established atherothrombotic disease.

Main Methods:

  • Utilized data from the REACH Registry of atherothrombosis.
  • Included patients with documented CAD, PAD, or CVD and a 4-year follow-up.
  • Compared event rates across geographical regions, adjusting for risk scores.

Main Results:

  • Significant geographical differences in baseline characteristics and medication use were observed.
  • The composite outcome (cardiovascular death, MI, stroke) ranged from 12.1% in Japan to 18.2% in Eastern Europe.
  • Adjusted analyses revealed lower risks in Japan (HR 0.67) and Western Europe (HR 0.93) versus North America, and higher risks in Eastern Europe (HR 1.24).

Conclusions:

  • Substantial geographical variations exist in the outcomes of patients with atherothrombotic diseases.
  • These findings highlight the need for region-specific approaches in public health and clinical research for atherothrombosis.
Abstract

Keywords:
Geographic differencesatherothrombotic diseasebleedingischemic outcomes

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