ESC: 70% stroke survivors die from cardiovascular event other than stroke

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Stable stroke patients more likely to die from a nonstroke cardiovascular (CV) event than a stroke, according to two-year data from the REACH Registry presented at the European Stroke Congress (ESC) in Nice, France last week.

The researchers noted that among those who die after a stroke, the vast majority (73 percent) will die from nonstroke CV event; the overall death rate is 4.45 percent, with 3.23 percent of these CV deaths from a nonstroke event.

The REACH Registry has demonstrated a high prevalence of atherothrombosis in more than one vascular bed: one-quarter of patients with coronary artery disease (CAD), two-fifths of patients with cerebrovascular disease and three-fifths of patients with peripheral artery disease (PAD) also have atherothrombosis in other arterial locations, according to researchers.

REACH investigators also highlighted the undertreatment of patients with cerebrovascular disease in the real-world setting and noted that improving ischemic risk management in the patients is required to prevent hospitalization and death.

Researchers said that approximately 28 percent of patients have been diagnosed with cerebrovascular disease at baseline, and about 40 percent of patients with cerebrovascular disease have polyvascular disease. Of the total cerebrovascular disease population at baseline: 71 percent suffered a prior stroke; 51 percent had a prior transient ischemic attack; and 20 percent had both, the authors reported.

Two-year data in the cerebrovascular disease population show high event rates for non-fatal stroke (5.9 percent), the researchers said. The risk of stroke, MI and CV death at two years was 11.5 percent for the total cerebrovascular disease population. Patients with a history of cerebrovascular disease are at considerable risk of major adverse cardiac events and hospitalizations (greater than 20 percent at two years), according to the REACH Registry.

The researchers noted that the results underscored the very high risk factor profile and high percentage of cerebrovascular disease patients with additional atherothrombotic disease manifestations in the REACH Registry.

“The REACH Registry continues to demonstrate the real-world burden of atherothrombotic disease worldwide. In the case of cerebrovascular disease, further analysis has re-emphasized the need for doctors to adhere to evidence-based guidelines for treatment such as long-term antiplatelet therapy or antihypertensive treatment,” said Gabriel Steg, MD, professor of cardiology at Hopital Bichat-Claude Bernard in Paris, on behalf of the REACH Registry's Scientific Council.