Atherothrombosis: epidemiology, pathophysiology, and prevention

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Thrombosis Research

Background:

• Atherothrombosis, characterized by atherosclerosis and superimposed thrombus formation, is a generalized vascular process.
• It underlies critical cardiovascular events such as acute coronary syndromes, ischemic stroke, and peripheral arterial disease.
• The clinical manifestations are often unpredictable and life-threatening.

Purpose of the Study:

• To review the pathophysiology of atherothrombosis.
• To outline preventive strategies including lifestyle modifications and pharmacotherapy.
• To emphasize the role of antiplatelet agents in managing atherothrombosis.

Main Methods:

• Literature search of Medline (1995-2003) using terms related to atherothrombosis, pathophysiology, risk factors, and treatment.
• Screening of recent systematic English-language review articles for relevant information.
• Synthesis of data on the mechanisms and management of atherothrombosis.

Main Results:

• Atherothrombosis, not just arterial stenosis, drives most acute ischemic events.
• Effective interventions include lifestyle changes (diet, exercise, smoking cessation) and pharmacotherapy (lipid-lowering, antihypertensive, antiglycemic, antiplatelet drugs).
• Platelets play a crucial role in thrombus formation, supporting the use of complementary antiplatelet agents like aspirin and clopidogrel.

Conclusions:

• Ischemic diseases in cerebrovascular, coronary, and peripheral arteries share a common pathology: atherothrombosis.
• Secondary prevention of an ischemic event in one arterial bed provides primary prevention for other beds.
• Comprehensive management of atherothrombosis is vital for preventing diverse clinical sequelae.