Assessment of Atherothrombosis and Its Treatment in Mexico: First-Year Data of the REACH Registry

Background: Atherothrombosis, a generalized and progressive process, is currently a major healthcare problem in Mexico. Methods: The worldwide Reduction of Atherothrombosis for Continued Health (REACH) registry aimed to evaluate risk factors for atherosclerosis, long-term cardiovascular (CV) event rates, and current management of either patients with established symptomatic atherosclerotic disease or asymptomatic subjects with multiple risk factors for atherothrombotic disease. One-year follow-up of the global REACH database was available for 64 977 outpatients. This report includes the Mexican subregistry wherein 62 internists, cardiologists, and neurologists evaluated baseline patient characteristics, risk factors, medications, and CV event rates as primary outcomes at 1-year follow-up. Results: Complete 1-year follow-up data were available for 837 Mexicans. We observed a high prevalence of diabetes (47.1%), hypertension (74.7%), and hypercholesterolemia (57.8%). Antiplatelet, antihypertensive and/or glucose-lowering agents, and lipid-lowering drugs were used in 87.6%, 84.1%, and 61% of patients, respectively. The all-cause mortality rate was 3.3%. The composite outcome CV death/myocardial infarction/stroke/hospitalization for atherothrombotic events was higher in the symptomatic group (14.6%) than in asymptomatic subjects with multiple risk factors (5.1%; P = 0.01), similar to Latin American results of the global REACH report. The highest CV event rate occurred among symptomatic atherothrombotic patients with 3 vascular disease locations (30.2%), followed by those with 2 (21.9%) and a location (13.4%; P = 0.0006). Conclusions: Prevalence of risk factors and CV event rates including hospitalization in Mexican atherothrombotic patients was high despite the current medication use, which suggests it is necessary to have more aggressive risk-factor management.