05.09.2007 – 11:08

REACH Registry

REACH Registry Highlights That Patients With Peripheral Arterial Disease (PAD) Suffer High Rates of Heart Attack, Stroke, Hospitalization, and Death

Vienna, Austria (ots/PRNewswire)

• New analyses presented in Europe for the first time underscores REACH implications for individuals with leg artery blockages
• Findings suggest the need for earlier, more aggressive therapeutic intervention

New analyses from the REACH Registry presented at the European
Society of Cardiology Congress 2007 underscore the REACH Registry
1-year results first published in the Journal of the American Medical
Association in March 2007. Outpatients with atherothrombosis have a
surprisingly high risk of death or major cardiovascular illness,
especially in the over 25 million patients internationally who have
peripheral arterial disease (PAD), or atherothrombosis in the leg
arteries.

Researchers evaluated the data from the Registry, which represents
the largest international population with PAD ever studied. Patients
with PAD suffer very high rates of heart attack, stroke or death, and
very high rates of hospitalization. These data again highlight that
establishing the PAD diagnosis identifies a very high risk which is
known to improve when the diagnosis is linked to guideline-mandated
risk reduction therapies. Lead author Dr. Alan T. Hirsch, professor
of epidemiology and community health at the University of Minnesota
School of Public Health; and director of the Minneapolis Heart
Institute's vascular medicine program at Abbott Northwestern's
Vascular Center in Minneapolis, Minn., presented the results today.

Dr. Hirsch noted, "PAD has long been known to represent a form of
artery disease that carries a high risk. The international REACH
Registry demonstrates that this cardiovascular risk in patients with
PAD remains remarkable in every nation, and is undoubtedly associated
with a high personal, family, community, and public health cost. One
in three individuals with PAD in office practice face a short-term
chance of dying, having a heart attack or stroke or being
hospitalized within two years. One in ten will die in this short time
frame. Therefore initiating therapy without delay to reduce this risk
is essential."

Despite improved PAD awareness, treatment and diagnosis during the
past five years, Hirsch and investigators hypothesized that
cardiovascular disease event rates would remain high, and that
complacency in treating this disease was not merited. The analysis of
international individuals enrolled in REACH found this to be true.
All individuals with PAD, regardless of symptom status or past use of
leg angioplasty or leg bypass remained at high risk.

"The REACH Registry continues to demonstrate the real-world burden
of atherothrombotic disease worldwide. In the case of PAD, further
analysis has re-emphasized the need for doctors to adhere to
evidence-based guidelines for treatment like long-term antiplatelet
therapy with aspirin or clopidogrel," said Dr. Gabriel Steg,
professor of cardiology at Hopital Bichat-Claude Bernard, Paris, on
behalf of the REACH Registry's Scientific Council. "But first
diagnosis must happen earlier and to do this the tools need to be
more readily available and reimbursed, especially in Europe."

Details on Hirsch Analysis

Results: REACH enrolled 8581 individuals with PAD, by asymptomatic
ABI<0.9 alone (8%); claudication (65%); prior limb revascularization
(50%); or amputation (13%). Risk factors were prevalent (diabetes
44%, current smoking 24%, hypercholesterolemia 66%). Antiplatelet
(81%), antihypertensive (87%), antidiabetic (40%), and lipid-lowering
therapies (70%) were well-utilized. Non-fatal CV disease events and
mortality remained high (Table). Leg angioplasty, vascular bypass, or
amputation occurred at annual rates of 7.6%, 5.3%, and 2.8%,
respectively.

In addition to the analysis on PAD, REACH investigators presented
posters on other sub-analyses during the European Society of
Cardiology Congress 2007:

    -- "Cardiovascular events of Asian patients at high risk of
       atherothrombosis compared with the rest of the world: Results from the
       REduction of Atherothrombosis for Continued Health (REACH) Registry"
       S. Goto, Y. Ikeda, JCN. Chan, PWF. Wilson, R. Zambahari, T-C. Yeo,
       C-S. Liau, TB. Abola, PG. Steg, DL. Bhatt
    -- "International variation in the rates of vascular hospitalizations in
       patients at risk of atherothrombosis: Results from the REACH Registry
       for U.S., France, and Germany" E M. Mahoney, K. Wang, DJ. Cohen, F.
       Mosse, J. Jackson, DL. Bhatt, PG. Steg, G. De Pouvourville
    -- "Cardiovascular risk profile and outcome of patients with an abdominal
       aortic aneurysm in the REACH Registry" Baumgartner, AT. Hirsch, TB.
       Abola, PP. Cacoub, D. Poldermans, PG. Steg, MA. Creager, K. Eagle, DL.
       Bhatt

Objectives and Scope of REACH

The overall aim of the REACH Registry is to improve the assessment
and management of stroke, heart attack and associated risk factors
for atherothrombosis. It is the largest and most geographically
extensive global registry of patients at risk of atherothrombosis,
having recruited over 68,000 patients in 44 countries, covering six
regions - Latin America, Asia, the Middle East, Australia, Europe and
North America - and involving over 5,000 physician investigators.

The REACH Registry includes a broad spectrum of patients with
atherothrombosis - documenting the health status and treatment of
people at risk of atherothrombosis; monitoring how they are affected;
and measuring the burden of the disease. Patients included in the
REACH Registry either have several of the risk factors that can lead
to atherothrombosis, such as, high cholesterol, high blood pressure,
smoking, and diabetes, or have a previous history of heart attack,
stroke or PAD. Participation in the REACH Registry is strictly
voluntary.

In addition, the REACH Registry is based in a real-life setting
and seeks to increase overall understanding of atherothrombotic
disease across several medical specialities (cardiology, neurology,
internal medicine, vascular medicine and office-based primary care
physicians), which allows for a more thorough assessment of the
real-world burden of the disease.

The Underlying Cause of Heart Attack, Stroke and PAD

Atherothrombosis occurs when a blood clot (thrombus) forms on a
ruptured plaque (atheroma) in the wall of a blood vessel. Plaques
consist of fatty acids and cholesterol, calcium and other materials.

The rupture of plaques and the subsequent development of a clot
can cause partial or complete blockage of an artery in various parts
of the body. When a vessel in the heart is partially or completely
blocked by a clot the result can be a heart attack. In the brain, the
same process can cause a stroke. Elsewhere in the body, this process
can lead to reduction or blockage of blood flow in the arteries of
the legs - PAD - a significant risk factor for heart attack or
stroke.

Atherothrombosis is thus the common thread linking heart attack,
stroke and peripheral arterial disease.

Notes to Editors:

REACH Registry

The REACH Registry is the first outpatient registry to
characterize real-world event rates and treatment patterns in a broad
spectrum of patients with atherothrombosis worldwide. The Registry
follows more than 60,000 patients over 4 years, involving 44
countries and 5,000 physician investigators. The REACH Registry aims
to improve the assessment and management of patients with a history
of coronary artery disease (CAD), cerebrovascular disease
(Stroke/TIA), peripheral arterial disease (PAD), and those with a
combination of high risk factors.

The REACH Registry is sponsored by Sanofi-Aventis, Bristol-Myers
Squibb, and the Waksman Foundation (Tokyo, Japan), who assisted with
the design and conduct of the study and data collection.

The REACH Registry is endorsed by the World Heart Federation.

REACH Registry Baseline Publication:

DL. Bhatt, PG. Steg, EM. Ohman, AT. Hirsch, Y. Ikeda, JL. Mas, S.
Goto, C-S. Liau, AJ. Richard, J. Rother, PWF. Wilson, on behalf of
the REACH Registry Investigators. International Prevalence,
Recognition, and Treatment of Cardiovascular Risk Factors in
Outpatients with Atherothrombosis. JAMA 2006;295:180-9.

    REACH Registry Scientific Council:
    -- Philippe Gabriel Steg, AP-HP, Hopital Bichat-Claude Bernard, Paris,
       France (co-chair)
    -- Deepak L. Bhatt, Cleveland Clinic, Cleveland, USA (co-chair)
    -- E. Magnus Ohman, Duke University, Durham, USA
    -- Joachim Rother, Universitat-Klinikum Minden, Minden, Germany
    -- Peter F. Wilson, Medical University of South Carolina, Charleston, USA

For further information on the REACH Registry please visit
www.REACHRegistry.org

Contact:
    Chantal Roshetar
     croshetar@ccapr.com, +1-917-605-0173

Web site: http://www.REACHRegistry.org

Contact:

Chantal Roshetar, +1-917-605-0173, croshetar@ccapr.com, for REACH
Registry