Vol. 44 | No. 1 | January-June 2016 Back

Open Access

Four-Year Clinical Outcomes of Filipino Patients with or at Risk for Atherothrombotic Events from the REACH Registry

Maria Teresa B. Abola, Felix Eduardo R. Punzalan, Artemio A. Roxas
Jun 2016 DOI 10.69944/pjc.c2db87b15a

Abstract

Background: Patients with established atherothrombotic disease (EAD) or those with atherothrombotic risk factors are at high risk for cardiovascular events and death. There are scant data on the clinical profile of stable Filipino patients with risk factors for atherothrombosis, and their long-term outcomes. 

Objective: To present the baseline clinical profile and four-year cardiovascular outcomes of Filipino out patients with EAD and those with multiple atherothrombotic risk factors. 

Methodology: The Reduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective cohort of 68,236 patients aged at least 45 years old with either EAD or at least three atherothrombotic risk factors enrolled from 44 countries from 2003 to 2004. The Philippine cohort consists of 913 patients with EAD and 127 subjects with at least three atherothrombotic risk factors, who were consecutively enrolled and followed up for at least one to four years for the occurrence of cardiovascular (CV) death, myocardial infarction (MI) or stroke. 

Results: Of the 1,040 Filipino patients enrolled, 995 completed the four-year follow-up (96%). Their mean age was 65.5 years, with a balanced sex distribution. Forty-six percent have diabetes, 87.4% have hypertension, 62.9% have hypercholesterolemia, and 29.7% are ever-smokers. Ninety two percent had EAD (43% with coronary artery disease, 45% with cerebrovascular disease and 4% with peripheral artery disease or PAD). The rate of the combined primary endpoint of CV death/MI/stroke was 14.7%, but was higher (19.8%) among those with poly-vascular disease. Cerebrovascular disease patients had the highest CV death/MI/stroke rates (17.6%). PAD patients had the highest CV death/MI/stroke and hospitalization rate (33.2%). At baseline, 81.1% were receiving antiplatelet agents, 62.6% were receiving statins and 69% were receiving either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. After the fourth year of follow-up, medication usage rates were lower at 72.6%, 62.3%, and 37.2%, respectively. 

Conclusions: Filipino outpatients with, or at risk for, atherothrombosis experienced high long-term rates of CV events. This is the first report of long-term CV outcomes of stable Filipino outpatients with this high-risk profile. 

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