Our preliminary data were presented at the International Stroke Conference in San Francisco, February 2007.
High cardiovascular event rates in patients with asymptomatic carotid stenosis: the REACH registry*
Article first published online: 31 MAR 2009
© 2009 The Author(s). Journal compilation © 2009 EFNS
European Journal of Neurology
Volume 16, Issue 8, pages 902–908, August 2009
How to Cite
Aichner, F. T., Topakian, R., Alberts, M. J., Bhatt, D. L., Haring, H.-P., Hill, M. D., Montalescot, G., Goto, S., Touzé, E., Mas, J.-L., Steg, P. G., Röther, J. and for the REACH Registry Investigators (2009), High cardiovascular event rates in patients with asymptomatic carotid stenosis: the REACH registry. European Journal of Neurology, 16: 902–908. doi: 10.1111/j.1468-1331.2009.02614.x
- Issue published online: 15 JUL 2009
- Article first published online: 31 MAR 2009
- Received 19 October 2008 Accepted 18 February 2009
- carotid artery stenosis;
- outcome assessment;
Background and purpose: Data on current cardiovascular event rates in patients with asymptomatic carotid artery stenosis (ACAS) are sparse. We compared the 1-year outcomes of patients with ACAS ≥70% versus patients without ACAS in an international, prospective cohort of outpatients with or at risk of atherothrombosis.
Methods: The Reduction of Atherothrombosis for Continued Health Registry enrolled patients with either ≥3 atherothrombotic risk factors or established atherothrombotic disease. We investigated the 1-year follow-up data of patients for whom physicians reported presence/absence of ACAS at the time of inclusion.
Results: Compared with patients without ACAS (n = 30 329), patients with ACAS (n = 3164) had higher age- and sex-adjusted 1-year rates of transient ischaemic attack (3.51% vs. 1.61%, P < 0.0001), non-fatal stroke (2.65% vs. 1.75%, P = 0.0009), fatal stroke (0.49% vs. 0.26%, P = 0.04), cardiovascular death (2.29% vs. 1.52%, P = 0.002), the composite end-point cardiovascular death/myocardial infarction/stroke (6.03% vs. 4.29%, P < 0.0001) and bleeding events (1.41% vs. 0.81%, P = 0.002). In patients with ACAS, Cox regression analyses identified history of cerebrovascular ischaemic events as most important predictor of future stroke (HR 3.21, 95% CI 1.82–5.65, P < 0.0001).
Conclusion: Asymptomatic carotid artery stenosis was associated with high 1-year rates of cardiovascular and cerebrovascular ischaemic events. Stroke was powerfully predicted by prior cerebrovascular ischaemic events.