The objective of this study was to determine cardiovascular event rates in diabetic
patients and nondiabetic subjects from the REACH Registry with established coronary
artery disease, cerebrovascular disease, peripheral arterial disease, or multiple
risk factors for atherothrombosis. REACH is an international, prospective, and contemporaneous
cohort of patients with ≥3 atherothrombotic risk factors only or established atherothrombotic
disease, of which 30,043 have diabetes. The main outcomes after 1-year follow-up were
cardiovascular death, myocardial infarction, stroke, major adverse cardiovascular
events (MACEs; cardiovascular death, myocardial infarction, or stroke), and MACEs/hospitalization.
The MACE rate at 1 year was positively related to the number of atherothrombotic anatomic
sites in diabetic patients and nondiabetic subjects, and the rate was higher in those
with (3.8%) than without (3.0%, p <0.001) diabetes. Diabetic patients with risk factors
only had a lower MACE rate than nondiabetic subjects or diabetic patients with established
atherothrombotic disease (2.2% vs 4.0% or 6.0%, respectively, p <0.001 for the 2 comparisons).
These differences persisted after adjusting for gender and age. In conclusion, diabetic
patients in the REACH Registry have an increased risk of cardiovascular events compared
to nondiabetic subjects related to the number of atherothrombotic sites. Although
increasing risk, diabetes may not be truly equivalent to previous atherothrombotic
events on new cardiovascular event rates.
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Article info
Publication history
Accepted:
October 13,
2009
Received in revised form:
October 13,
2009
Received:
July 8,
2009
Footnotes
The REACH Registry is sponsored by Sanofi-Aventis (Paris, France), Bristol-Myers Squibb (Paris, France), and the Waksman Foundation (Tokyo, Japan).
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
