Atherothrombosis as a marker for disseminated atherosclerosis and a predictor of further ischaemic events - A review

Atherosclerosis and atherothrombosis are the major pathophysiological proce sses involved in ischaemic stroke, coronary heart disease and peripheral ar terial disease. Clinical evidence of atherosclerosis in one vascular bed is widely believed to reflect more widespread atheromatous disease. This arti cle provides a comprehensive review of epidemiological studies of atheroscl erotic disease profiles at baseline and patient outcomes during follow-up i n those with evidence of atherosclerosis. The data reveal that a high perce ntage of patients have atherosclerosis in more than one vascular territory, although the precise nature of the overlap varies with patient gender and age and the presence of cardiovascular risk factors. Patients with a previo us atherothrombotic event are subject to an increased likelihood of death o r morbidity nor only due to a recurrent event in the same vascular bed, but also to an atherothrombotic event in any other vascular bed. Those with at herosclerotic involvement in all three vascular territories represent a par ticularly high-risk population. The evidence reviewed here demonstrates tha t atherothrombosis is a global vascular disease, requiring global assessmen t and global treatment. Therapeutic agents should have broad utility for th e prevention of vascular ischaemic events in patients with coronary, cerebr ovascular and peripheral arterial disease.