Abstract 4022: Control of Cardiovascular Risk Factors in Peripheral Arterial Disease Patients in the REduction in Atherothrombosis for Continued Health (REACH) Registry
Objectives: To compare the control status of key atherosclerosis risk factors (RF) in patients with and without peripheral arterial disease (PAD) in the REACH Registry.
Methods: The REACH Registry recruited >68,000 outpatients aged ≥45 years with established atherosclerotic disease or ≥3 RFs for atherothrombosis from 44 countries worldwide. We assessed a series of predictors of RF control, including:
mode of PAD diagnosis (ABI< 0.9, angioplasty or surgery of the lower limbs, lower limb amputation); and
extent of atherothrombotic disease (coronary artery disease [CAD] and cerebrovascular disease [CVD]).
Results: Patients with PAD (n=8,322) compared with those without (n=47,429) had less frequently controlled RFs according to guideline recommendations i.e. SBP <140 mmHg (46 vs 57%), DBP <90 mmHg (79 vs 81%), glycemia <110 mg/dL (53 vs 59%), total cholesterol level <200 mg/dL (56 vs 63%), and smoking cessation for >12 months (76 vs 87%) (p<0.001). Factors by multivariate analysis independently associated with control of the 5 major RFs in patients with PAD were male gender (OR=2.1), residence in North America (OR=2.9) or Japan (OR=2.7), previous CABG (OR=1.6), and statin use (OR=1.9); whereas a previous history of a lower limb amputation was a negative predictor (OR=0.6) (p<0.001) (Table⇓).
Conclusion: In the REACH Registry, patients with PAD did not achieve RF control as frequently as individuals with CAD. Individuals with PAD were more likely to enjoy improved RF management if they were male, living in North America or Japan, had previous CABG, and/or used a statin. Individuals who had suffered previous lower limb amputation were least likely to achieve RF control. These treatment disparities provide specific targets for physician and patient educational interventions.