ESC: In Atherothrombosis, Clinical Descriptors Predict Risk

Those with history of ischemic events most vulnerable to subsequent events
By Monica Smith
HealthDay Reporter

MONDAY, Aug. 30 (HealthDay News) -- Researchers have identified clinical descriptors that can help clinicians identify which patients with atherothrombosis are at highest risk for future cardiovascular events. This research has been published online Aug. 30 in the Journal of the American Medical Association to coincide with the European Society of Cardiology Congress, held from Aug. 28 to Sept. 1 in Stockholm, Sweden.

Deepak L. Bhatt, M.D., of Harvard Medical School in Boston, and colleagues studied data on 45,227 outpatients with peripheral arterial disease, cerebrovascular disease, coronary artery disease, or multiple risk factors for atherothrombosis. They followed the patients for four years to identify categories of risk for cardiovascular events in this patient population based on simple clinical descriptors.

At least one event, including cardiovascular death, myocardial infarction, and stroke, occurred in 5,481 of these patients. Among the patients with atherothrombosis, the researchers found that the highest rate of subsequent ischemic events (18.3 percent) occurred in those with a history of ischemic events at baseline. Those with stable coronary, cerebrovascular, or peripheral artery disease were at lower risk (12.2 percent), while those without atherothrombosis but with risk factors were at lowest risk (9.1 percent). With multivariable modeling, the researchers found that diabetes, an ischemic event in the previous year, and polyvascular disease were associated with the rate of cardiovascular events (hazard ratios, 1.44, 1.71, and 1.99, respectively).

"Clinical descriptors can assist clinicians in identifying high-risk patients within the broad range of risk for outpatients with atherothrombosis," the authors write.

Sanofi-Aventis and Bristol-Myers Squibb sponsored the Reduction of Atherothrombosis for Continued Health Registry, from whose enrollees the data for this study were taken. Study authors disclosed financial relationships with these and other pharmaceutical and/or medical device companies.

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