-- Robert Preidt
MONDAY, Aug. 30 (HealthDay News) -- A number of factors put
patients with abnormal fatty deposits in an artery at high risk for
heart attack, stroke and cardiovascular death, a new study
Patients in various stages of this condition -- atherothrombosis
-- are at increased risk for heart attack and stroke stemming from
reduced blood flow from the artery blockage, but some are at
greater risk than others. In an analysis of more than 45,000
patients, the researchers found that patients with abnormal fatty
deposits in an artery were at highest risk if they had a prior
history of heart attack or other emergencies linked to an artery
Narrowing of the arteries in various locations also
substantially increased the risk for patients with
atherothrombosis, as did diabetes for all the patients -- even
those with only the risk factors for atherothrombosis.
Knowing that these factors boost the risk can help physicians
take preventive action, according to the researchers, who are from
the VA Boston Healthcare System, Brigham and Women's Hospital and
Harvard Medical School in Boston.
The researchers analyzed data from 45,227 patients enrolled in
an international study known as Reduction of Atherothrombosis for
Continued Health (REACH) between 2003 and 2004. They collected
detailed information from the patients when they enrolled and
conducted follow-ups one, two, three and four years later.
They found that 81.3 percent of the patients had hypertension,
70.4 percent had high cholesterol levels in the blood, and 15.9
percent had polyvascular disease (narrowing of the arteries in
numerous locations). In addition, 48.4 percent of the patients had
"ischemic events" -- prior heart attacks, unstable angina or other
problems related to the artery blockage, with 28.1 percent of those
patients having had such an event within the previous year.
During the follow-up period, 2,315 patients suffered
cardiovascular death, 1,228 had a heart attack, 1,898 had a stroke,
and 40 had a heart attack and a stroke on the same day.
The researchers found that patients with atherothrombosis with a
prior history of heart attacks and other events related to a blood
vessel blockage had the highest rate of subsequent cardiac
emergencies linked to blood flow problems. Patients with stable
heart, cerebrovascular or peripheral artery disease had a lower
risk, while the risk was lowest among those with risk factors for
atherothrombosis but without established disease.
"Among all categories of patients, diabetes substantially increase the risk of future ischemic events," the study authors wrote. "In those with established atherothrombosis, polyvascular disease was a particularly strong independent risk factor, even stronger than diabetes."
The findings show that "there is a whole spectrum of
[emergencies relating to artery blockage and blood flow] in
patients with risk factors or with established cardiovascular
disease -- easily ascertainable clinical characteristics are the
prominent factors associated with a high risk of future ischemic
events," they concluded.
The study appears online and in the Sept. 22 issue of the
Journal of the American Medical Association and is slated to
be presented Monday at the European Society of Cardiology meeting
The U.S. National Heart, Lung, and Blood Institute has more
heart and vascular diseases.
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