Importance of polyvascular disease (PolyVD). Prognosis, screening and therapy

Abstract

As a generalised vascular disease, atherosclerosis can affect different vascular territories (carotid, coronary, lower limb, renal, and aorta) to different degrees. Polyvascular disease refers to atherosclerotic disease in more than one vascular territory. In contrast to the involvement of only one vascular territory, the multiple vascular territory form, as a varied phenotype, has been shown in numerous epidemiological studies to carry an increased cardiovascular risk (morbidity and mortality). While the recognition of the varied presentation is considered important for prognosis, given the screening vascular tests for disease detection are available, data on whether the detection of asymptomatic conditions by screening can meaningfully alter the treatment strategy are scarce. A subgroup analysis of new drug therapy trials suggests that proactive, intensive treatment of polyvascular disease (antilipemic, antithrombotic) is recommended, taking into account safety. There is a great need to design therapeutic clinical trials using different phenotypes of polyvascular disease as a study group. Optimal management of this high-risk group of patients requires effective multidisciplinary collaboration in patient management.

Keywords

• atherosclerosis
• polyvascular disease
• cardiovascular screening
• antilipemic therapy
• antithrombotic therapy