Clinical descriptors can assist in alerting patients with atherothrombosis to the risk factors behind developing cardiovascular problems.
The study is being released early online to coincide with its presentation at the European Society of Cardiology meeting in Stockholm.
"Patients with atherothrombosis are at elevated risk of ischemic events [such as heart attack or stroke] but, depending on their specific manifestations of atherothrombosis, may have varying degrees of future risk for ischemic events," the authors write as background in the article. "For clinicians, the ability to identify rapidly the major determinants of risk among patients with atherosclerosis would be useful to triage novel preventive therapies toward those at the higher end of the spectrum."
During the follow-up period, 5,481 patients experienced cardiovascular events including 2,315 with cardiovascular death, 1,228 with myocardial infarction (heart attack), 1,898 with stroke and 40 with both a myocardial infarction and stroke occurring on the same day. Additionally, among patients with atherothrombosis, those with a prior history of ischemic events at baseline had the highest rate of subsequent ischemic events, while patients with stable coronary, cerebrovascular or peripheral artery disease had a lower risk. Patients without established atherothrombosis but with risk factors only had the lowest risk of subsequent ischemic events.
"Among all categories of patients, diabetes substantially increased the risk of future ischemic events," the authors write. "In those with established atherothrombosis, polyvascular disease was a particularly strong independent risk factor, even stronger than diabetes." Additionally, the authors conclude that, "this analysis of a contemporary, international cohort of patients at various stages of atherothrombosis shows that there is a whole spectrum of ischemic risk in patients with risk factors or with established cardiovascular disease and that easily ascertainable clinical characteristics are the prominent factors associated with a high risk of future ischemic events."