Russo Michele, Gurgoglione Filippo Luca, Russo Alessandro, Rinaldi Riccardo, Torlai Triglia Laura, Foschi Matteo, Vigna Carlo, Vergallo Rocco, Montone Rocco Antonio, Benedetto Umberto, Niccoli Giampaolo, Zimarino Marco
Department of Cardiology, SS. Annunziata Hospital, ASL2 Abruzzo, 66100 Chieti, Italy.
Department of Cardiology, F. Renzetti Hospital, ASL2 Abruzzo, 66034 Lanciano, Italy.
Life (Basel). 2025 Aug 3;15(8):1226. doi: 10.3390/life15081226.
Coronary artery disease (CAD) is the main cause of morbidity and death worldwide, and atherosclerosis represents the leading pathophysiological pathway responsible for CAD. Atherosclerotic process is a complex interplay of mechanisms and mediators resulting in plaque formation, progression and destabilization, the latter being the most frequent cause of acute cardiovascular events. Considering the systemic nature of atherosclerosis, polyvascular disease involvement is possible and has been described since 1960s. Accordingly, epidemiologic studies reported that concomitant CAD and atherosclerosis in other arterial beds like carotid arteries, lower limb arteries, mesenteric and renal circulation, and aorta, is frequent and related to increased chance of future cardiovascular events. Although risk factors, atherosclerotic plaque features and mechanisms of plaque destabilization are largely shared across different sites, many studies have reported some disparities among districts. Moreover, simultaneous polyvascular disease has been associated with increased likelihood of having particular plaque characteristics depending on the affected arterial level. In this comprehensive narrative review, we aim to discuss about epidemiology of concomitant CAD and atherosclerosis in other arterial beds, and to examine differences in risk factors, plaque features and mechanisms of plaque instability between CAD and other atherosclerotic locations. Finally, we review the studies observing differences on plaque features according to involved atherosclerotic sites, focusing on CAD.
冠状动脉疾病（CAD）是全球发病和死亡的主要原因，动脉粥样硬化是导致CAD的主要病理生理途径。动脉粥样硬化过程是多种机制和介质相互作用的复杂过程，导致斑块形成、进展和不稳定，后者是急性心血管事件最常见的原因。考虑到动脉粥样硬化的全身性，多血管疾病受累是可能的，自20世纪60年代以来就有相关描述。因此，流行病学研究报告称，CAD与其他动脉床（如颈动脉、下肢动脉、肠系膜和肾循环以及主动脉）的动脉粥样硬化同时存在很常见，并且与未来心血管事件发生几率增加有关。尽管不同部位的危险因素、动脉粥样硬化斑块特征和斑块不稳定机制在很大程度上是相同的，但许多研究报告了不同部位之间存在一些差异。此外，同时发生的多血管疾病与根据受影响动脉水平出现特定斑块特征的可能性增加有关。在这篇全面的叙述性综述中，我们旨在讨论CAD与其他动脉床中动脉粥样硬化同时存在的流行病学，并研究CAD与其他动脉粥样硬化部位在危险因素、斑块特征和斑块不稳定机制方面的差异。最后，我们回顾了根据受累动脉粥样硬化部位观察斑块特征差异的研究，重点是CAD。
