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14.05.2024 | Ischemic Heart Disease (D Mukherjee, Section Editor)

Polyvascular Disease: A Narrative Review of Risk Factors, Clinical Outcomes and Treatment

verfasst von: Manasi Tannu, Connie N. Hess, J. Antonio Gutierrez, Renato Lopes, Rajesh V. Swaminathan, S. Elissa Altin, Sunil V. Rao

Erschienen in: Current Cardiology Reports

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Abstract

Purpose of Review

Polyvascular disease has a significant global burden and is associated with increased risk of major adverse cardiac events with each additional vascular territory involved. The purpose of this review is to highlight the risk factors, associated outcomes, emerging genetic markers, and evidence for screening and treatment of polyvascular disease.

Recent Findings

Polyvascular disease is the presence of atherosclerosis in two or more vascular beds. It has a significant global burden, with a prevalence of 30–70% in patients with known atherosclerosis. Patients with polyvascular disease experience elevated rates of cardiovascular death, myocardial infarction and stroke, especially among high-risk subgroups like those with type 2 diabetes mellitus and there is a step-wise increased risk of adverse outcomes with each additional vascular territory involved. Genetic analyses demonstrate that some individuals may carry a genetic predisposition, while others exhibit higher levels of atherogenic lipoproteins and inflammatory markers. Routine screening for asymptomatic disease is not currently recommended by major cardiovascular societies unless patients are high-risk. While there are no established protocols for escalating treatment, existing guidelines advocate for lipid-lowering therapy. Additionally, recent studies have demonstrated benefit from antithrombotic agents, such as P2Y₁₂ inhibitors and low-dose anticoagulation, but the optimal timing and dosage of these agents has not been established, and the ischemic benefit must be balanced against the increased risk of bleeding in the polyvascular population.

Summary

Due to the high prevalence and risks associated with polyvascular disease, early identification and treatment intensification are crucial to reduce disease progression. Future research is needed to develop screening protocols and determine the optimal timing and dosing of therapy to prevent ischemic events.

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Titel: Polyvascular Disease: A Narrative Review of Risk Factors, Clinical Outcomes and Treatment
verfasst von: Manasi Tannu
Connie N. Hess
J. Antonio Gutierrez
Renato Lopes
Rajesh V. Swaminathan
S. Elissa Altin
Sunil V. Rao
Publikationsdatum: 14.05.2024
Verlag: Springer US
Erschienen in: Current Cardiology Reports
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-024-02063-0

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Polyvascular Disease: A Narrative Review of Risk Factors, Clinical Outcomes and Treatment

Abstract

Purpose of Review

Recent Findings

Summary

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