The average age of the enrollees at baseline was 68; two-thirds were men. Nearly half had a prior ischemic event, 44% had a history of diabetes, 28% had an ischemic event during the prior year, and 16% had polyvascular disease, defined as atherosclerotic disease in at least two vascular beds: coronary, cerebrovascular, or peripheral. During follow-up, the participants had 5,481 events—cardiovascular death, myocardial infarction, or stroke.
In a multivariable regression model, polyvascular disease at baseline linked with a twofold increased risk for an ischemic event during follow-up, compared with enrollees with no history of clinical cardiovascular events but with markers that placed them at risk, such as hypertension or hypercholesterolemia. Patients with a history of a recent ischemic event had a 70% higher risk for a follow-up event compared with enrollees without an event history. Patients with diabetes at enrollment had a 44% increased risk for a follow-up event compared with participants without diabetes, which did match the increased risk from an older ischemic event. Heart failure also appeared as a strong risk factor. “Our analysis provides simple criteria for assessing the risk of cardiovascular events in stable outpatients,” Dr. Bhatt said.
Concurrently with Dr. Bhatt's report, the results were published online (JAMA 2010 Aug. 30 [doi: 10.1001/jama.2010.1322])
Polyvascular disease at baseline linked with a twofold increased risk for an ischemic event during follow-up.
Source DR. BHATT