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Review
. 2019 Dec;12(12):e007385.
doi: 10.1161/CIRCINTERVENTIONS.119.007385. Epub 2019 Dec 13.

Polyvascular Disease: Reappraisal of the Current Clinical Landscape

J Antonio Gutierrez  1 , Aaron W Aday  2 , Manesh R Patel  1 , W Schuyler Jones  1
Affiliations
Review

Polyvascular Disease: Reappraisal of the Current Clinical Landscape

J Antonio Gutierrez et al. Circ Cardiovasc Interv. 2019 Dec.

Abstract

Atherosclerosis within 2 or more arterial beds has been termed polyvascular disease. Although polyvascular disease has long been associated with heightened cardiovascular risk, much is still unknown regarding its pathophysiology and management. In this past decade, the field of cardiovascular disease has experienced exponential growth in terms of antithrombotic and lipid-lowering therapies aimed at mitigating ischemic events. This review describes the inherent risk associated with polyvascular disease in contemporary observational and clinical trial populations and summarizes novel therapies in this high-risk population.

Keywords: atherosclerosis; cardiovascular diseases; lipids; myocardial infarction; stroke.

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Figures

Figure 1.
Figure 1.. Risk of Major Adverse Cardiac Events in Polyvascular Disease
Figures display hazard ratios and 95% confidence intervals of polyvascular disease in clinical registries and randomized controlled trials. A. REACH Registry data comparing cardiovascular risk factors alone to symptomatic atherosclerotic disease in a single versus 2–3 arterial beds B. SAVOR TIMI 53 Trial C. EUCLID Trial D. IMPROVE-IT Trial CI, confidence interval; CV, cardiovascular; MI, myocardial infarction; PAD, peripheral artery disease; CVD; cerebrovascular disease; CAD, coronary artery disease; DM2, type 2 diabetes mellitus
Figure 2.
Figure 2.. Polyvascular Disease and use of Novel Therapies (Central Figure)
MACE = major adverse cardiac events
See this image and copyright information in PMC

References

    1. Bhatt DL, Eagle KA, Ohman EM, Hirsch AT, Goto S, Mahoney EM, Wilson PW, Alberts MJ, D’Agostino R, Liau CS, et al. Comparative determinants of 4-year cardiovascular event rates in stable outpatients at risk of or with atherothrombosis. JAMA. 2010; 304:1350–1357. - PubMed
    1. Bhatt DL, Peterson ED, Harrington RA, Ou FS, Cannon CP, Gibson CM, Kleiman NS, Brindis RG, Peacock WF, Brener SJ, et al. Prior polyvascular disease: risk factor for adverse ischaemic outcomes in acute coronary syndromes. Eur Heart J. 2009; 30:1195–1202. - PubMed
    1. Hirsh J, Bhatt DL. Comparative benefits of clopidogrel and aspirin in high-risk patient populations: lessons from the CAPRIE and CURE studies. Arch Intern Med. 2004; 164:2106–2110 - PubMed
    1. Bonaca MP, Creager MA, Olin J, Scirica BM, Bohula EA, Murphy SA, Braunwald E, Morrow DA. Vorapaxar reduces peripheral revascularization regardless of number of diseased territories: insights from the TRA2°P-TIMI 50 trial. American College of Cardiology Scientific Sessions. 2013.
    1. Bonaca MP, Bhatt DL, Storey RF, Steg PG, Cohen M, Kuder J, Goodrich E, Nicolau JC, Parkhomenko A, Lopez-Sendon J, et al. Ticagrelor for prevention of ischemic events after myocardial infarction in patients with peripheral artery disease. J Am Coll Cardiol. 2016; 67:2719–2728. - PubMed

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