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Prof. Cacoub has received research grants from sanofi-aventis,
Schering Plough, Servier, Roche, Encysive and Gilead; honoraria
from sanofi-aventis, Schering Plough, Servier, Roche, Encysive,
Gilead, AstraZeneca, and Bristol-Myers Squibb.
Dr. Abola has received honoraria from sanofi-aventis, Pfizer,
Otsuka and Bayer; amember of an advisory board sponsored by
sanofi-aventis and has received study grants from AstraZeneca,
Boehringer-Ingelheim, Mayer, MSD, Otsuka, Pfizer, sanofi-aventis
and Servier.
Prof. Baumgartner: None declared.
Dr.Bhatt discloses the following relationships: Research Grants
(directly tothe institution) –Bristol-Myers Squibb, Eisai, Ethicon,
sanofi-aventis, The Medicines Company; Honoraria (donated to
non-profits for >2years) –Astra Zeneca, Bristol-Myers Squibb,
Centocor, Daiichi-Sankyo, Eisai, Eli Lilly, GlaxoSmithKline, Millennium,
Paringenix, PDL, sanofi-aventis, Schering Plough, The
Medicines Company, tns Healthcare; Speaker’s bureau (>2 years
ago)–Bristol-Myers Squibb, sanofi-aventis, The Medicines Company;
Consultant/Advisory Board (any honoraria donated to
non-profits) –Astra Zeneca, Bristol-Myers Squibb, Cardax, Centocor,
Cogentus, Daiichi-Sankyo, Eisai, Eli Lilly, GlaxoSmithKline,
Johnson &Johnson, McNeil, Medtronic, Millennium, Otsuka, Paringenix,
PDL, Philips, Portola, sanofi-aventis, Schering Plough, The
Medicines Company, tns Healthcare, Vertex; Expert testimony
regarding clopidogrel (the compensation was donated to anonprofit
organization); Cleveland Clinic Coordinating Center currently
receives or has received research funding from: Abraxis, Alex-
P.P. Cacoub et al. /Atherosclerosis 204 (2009) e86–e92 e91
if they were atthe target ofthe international guideline recomion Pharma, AstraZeneca, Atherogenics, Aventis, Biosense Webster,
mendations, regardless of whether patients received aspecific RF Biosite, Boehringer Ingelheim, Boston Scientific, Bristol-Myers
treatment or not. We arenot able to discern definitively howmany Squibb, Cardionet, Centocor, Converge Medical Inc., Cordis, Dr.
patients were exposed toeach RFbeyond self-report, nor for how Reddy’s, Edwards Lifesciences, Esperion, GE Medical, Genentech,
long each CVRFwas present before entry inthe REACH Registry. Gilford, GSK, Guidant, J&J, Kensey-Nash, Lilly, Medtronic, Merck,
Individuals with unstable atherothrombotic disease at baseline Mytogen, Novartis, Novo Nordisk, Orphan Therapeutics, P&G
were excluded. Despite the large sample size, these findings may Pharma, Pfizer, Roche, Sankyo, sanofi-aventis, Schering-Plough,
not beextrapolated to patients with PAD who are identified from Scios, St. Jude Medical, Takeda, TMC, VasoGenix, Viacor.
other settings or who do nothavepreviouslyestablishedPAD. Fur- Prof. Creager is the recipient of research grants from sanofithermore,
patients enrolledinthe REACH Registryhad established aventis and Merck and is on the speaker’s bureau for the
PAD and the proportion of patients with symptomatic manifesta- Bristol-Myers Squibb –sanofi-aventis Partnership. He is aconsultions
of PADishigher compared with manyepidemiological studies tant for Genzyme, Merck, Sigma Tau, and Vascutec.
that detected PAD byABI measurement [24]. Generalizability to Prof. Liau has received honoraria from sanofi-aventis.
those patients with only abnormal ABI is therefore not possible. Prof. Goto has received honoraria and consulting fees from
As aresult, good RF control and treatment may beoverestimated Eisai, sanofi-aventis, Daiichi-Sankyo, GlaxoSmithKline, Bristolin
the REACH Registry, even if patients are not reaching targets Myers Scribb, Otsuka, Bayer, Schering-Plough, Takeda, Astellas,
for risk factor control and following guideline therapies. Finally, AstraZeneca, Novartis and Kowa. Prof. Goto also received research
as for all registries, the influence of recruitment biases cannot be grants from Pfizer, Ono, Eisai, Otsuka, Daiichi-Sankyo, sanofi-
known; however, substantial efforts were undertaken to ensurethe aventis, Takeda and Astellas within the last 3years.
inclusion of representative patients from everyparticipating coun- Prof. Röther has received payment for Speakers’ Bureau
try. Physicians were instructed to recruit consecutive patients, but and consultancy fees from Boehringer-Ingelheim, sanofi-aventis,
unlike inarandomized controlled trial, there were nolog books Bristol-Myers Squibb and Merck Sharpe and Dome.
audited to ensure compliance with such instructions.
Prof. Steg has receivedhonoraria for advisoryboardattendance
FOR ELECTRONIC
and consulting fees from AstraZeneca, Boehringer-Ingelheim,
Bristol-Myers Squibb, GlaxoSmithKline, Merck Sharpe and Dohme,
5. ConclusionFOR FOR ELECTRONIC
and consulting fees from AstraZeneca, Boehringer-Ingelheim,
Bristol-Myers Squibb, GlaxoSmithKline, Merck Sharpe and Dohme,
Conclusion
Nycomed, sanofi-aventis, Servier,Takeda, The Medicines Company;
speakers bureaufromBoehringer-Ingelheim, Bristol-Myers Squibb,
Patients with PADdonot achieve RF control as frequentlyasindi-
frequentlyasindi-
GlaxoSmithKline, Nycomed, sanofi-aventis, Servier, ZLB Behring
viduals with other establishedatherothrombotic diseases (i.e. CAD
and Research Grant from sanofi-aventis within the last 3years.
or CVD). Improved RF control is associated with apositive impact on
DISTRIBUTION
Dr. Hirsch has received research ONLY
ONLY
grants from Bristol-Myers
major CV events after1year of follow-up. The identifiedtreatment
Squibb and and sanofi-aventis and honoraria from sanofi-aventis.
disparities should should provide impetus for moredirected physician and
patient education, and serve tostimulate healthcare professionals
globally toadhere toguidelines that designate therapeutic targets
Acknowledgements
for patients with PAD.
We thank Dominique Roome, MD and In-Ha Kim, MD of
6. Conflict ofinterest disclosures for authors
sanofi-aventis, and Brian Gavin, PhD and Ashish Pradhan, MD of
Bristol-Myers Squibb, for their support of the REACH Registry. The
REACH Registry enforces anoghost-writing policy. Wethank the
REACH Editorial Support Group for providing editorial help and
assistance in preparing this manuscript including editing, checking
content and language, formatting, referencing and preparing
tables and figures. The REACH Registry isendorsed bythe World
Heart Federation.
Funding: The REACH Registry issponsored by sanofi-aventis
(Paris, France), Bristol-Myers Squibb (Princetown, NewJersey, USA),
and the Waksman Foundation (Tokyo, Japan). The sponsors provide
logistical support. All the publication activity is controlled by
the REACH RegistryGlobal Publication Committee (Ph. Gabriel Steg,
Deepak L. Bhatt, MarkAlberts, Ralph D’Agostino, Kim Eagle, Shinya
Goto, Alan T. Hirsch, Chiau-Suong Liau, Jean-Louis Mas, E. Magnus
Ohman, Joachim Röther, Sidney C.Smith, Peter W.F. Wilson).
All manuscripts in the REACH Registry are prepared by independent
authors who are not governed bythe funding sponsors and
are reviewed byanacademic publication committee before submission.
The funding sponsors have the opportunity to review
manuscript submissions but do not have authority to change any
aspect of amanuscript.
Appendix A
A.1. REACH Registry Global Publication Committee
Mark Alberts, MD, NorthWestern University Medical School,
Chicago; Deepak L. Bhatt, MD, VA Boston Healthcare System and