Cardiovascular risk factor control and outcomes in peripheral artery disease patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry

Objectives: To examine differences in risk factor (RF) management between peripheral artery disease (PAD) and coronary artery (CAD) or cerebrovascular disease (CVD), as well as the impact of RF control on major 1-year cardiovascular (CV) event rates. Methods: The REACH Registry recruited >68000 outpatients aged ≥45 years with established atherothrombotic disease or ≥3 RFs for atherothrombosis. The predictors of RF control that were evaluated included: (1) patient demographics, (2) mode of PAD diagnosis, and (3) concomitant CAD and/or CVD. Results: RF control was less frequent in patients with PAD (n = 8322), compared with those with CAD or CVD (but no PAD, n = 47492) [blood pressure; glycemia; total cholesterol; smoking cessation (each P < 0.001)]. Factors independently associated with optimal RF control in patients with PAD were male gender (OR = 1.9); residence in North America (OR = 3.5), Japan (OR = 2.5) or Latin America (OR = 1.5); previous coronary revascularization (OR = 1.3); and statin use (OR = 1.4); whereas prior leg amputation was a negative predictor (OR = 0.7) (P < 0.001). Optimal RF control was associated with fewer 1-year CV ischemic symptoms or events. Conclusions: Patients with PAD do not achieve RF control as frequently as individuals with CAD or CVD. Improved RF control is associated with a positive impact on 1-year CV event rates.