Coronary artery diseaseCurrent Use of Aspirin and Antithrombotic Agents in the United States Among Outpatients With Atherothrombotic Disease (from the REduction of Atherothrombosis for Continued Health [REACH] Registry)
Section snippets
Methods
The REACH Registry is an international, prospective, longitudinal study of >68,000 patients across 6 continents recruited from December 2003 to June 2004.4, 5, 6 The present report was based on a database lock of July 2006. The methods have been described previously.6 In brief, the patients were eligible for enrollment if they were aged ≥45 years and had ≥1 of the following: (1) ≥3 atherothrombotic risk factors; (2) documented coronary artery disease (CAD); (3) documented cerebrovascular
Results
A total of 25,686 patients were registered in the REACH database from 1,599 practices in the US. At baseline, 15,360 (59.8%) had CAD, 5,478 (21.3%) had cerebrovascular disease, 2,382 (9.3%) had PAD, and 6,617 (25.8%) were asymptomatic with risk factors only. Of those with CAD, 11,677 had undergone previous angioplasty/stenting or coronary artery bypass surgery. Of those with cerebrovascular disease, 792 had previously undergone carotid angioplasty/stenting or carotid surgery. Of the patients
Discussion
In this large registry of >25,000 outpatients in the US with documented vascular disease or multiple risk factors, 70% of those enrolled were using aspirin. The most common dose of aspirin was 75 to 100 mg/day. This widespread use of low-dose aspirin was supported by the lack of additional clinical benefit1 and increased risk of major bleeding2 observed with higher doses. Among the aspirin nonusers, nearly 1/2 were taking other antithrombotic agents, although approximately 15% were not using
Acknowledgment
This report was written and edited by the authors, who take full responsibility for its content. The first draft was written by C. P. Cannon, MD. We wish to thank Susan Abulhawa, MS, and Melanie Leiby, PhD, for their editorial assistance with coordinating the revisions and creating the figures, and Danielle M. Brennan, MS, for her support with statistical analyses. The Cleveland Clinic Coordinating Center for Clinical Research verified all statistical analyses.
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The REduction of Atherothrombosis for Continued Health (REACH) Registry, statistical support, and editorial assistance were supported by the Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership, New York, New York. The REACH Registry has been endorsed by the World Heart Federation, Geneva, Switzerland.