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The Link between Arterial Atherosclerotic Disease and Venous Thromboembolic Disease
Pavel Poredos1,2, Peter Poredos2,3, Mateja K Jezovnik4
1Department of Vascular Disease, University Medical Center Ljubljana, Slovenia.
Insights
Arterial atherosclerotic and venous thromboembolic diseases share common risk factors and similar inflammatory mechanisms. This suggests a unified approach to prevention and treatment could improve outcomes for both vascular conditions.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Thrombosis Research
Background:
- Arterial atherosclerotic (AA) and venous thromboembolic (VTE) diseases are traditionally viewed as distinct entities.
- Emerging evidence highlights significant links and shared characteristics between AA and VTE.
- Understanding these connections is crucial for comprehensive vascular disease management.
Purpose of the Study:
- To review the relationship between arterial and venous vascular diseases.
- To explore common risk factors and etiological mechanisms.
- To discuss the implications for unified prevention and treatment strategies.
Main Methods:
- Narrative review of existing literature.
- Analysis of shared risk factors (dyslipidemia, metabolic syndrome, thrombophilia).
- Examination of common pathogenetic mechanisms, particularly inflammation.
Main Results:
- Shared risk factors like dyslipidemia and metabolic syndrome are prevalent in both AA and VTE.
- Inflammation plays a key role in the pathogenesis of both conditions, promoting coagulation.
- Evidence links preclinical/clinical atherosclerosis with VTE, suggesting atherosclerosis may induce VTE or share common drivers.
- Pharmacological interventions like antiplatelets, anticoagulants, and statins show efficacy in preventing both AA and VTE.
Conclusions:
- Arterial and venous diseases share fundamental pathophysiological mechanisms and common risk factors.
- A unified approach to the prevention and treatment of these vascular conditions is warranted.
- Addressing shared pathways may lead to improved patient outcomes in both arterial and venous diseases.
Abstract:
Traditionally, arterial atherosclerosis (AA) and venous thromboembolic (VTE) diseases have been separated into two independent entities. However, a body of evidence suggests the link between arterial and venous disease. In this narrative review, the relationship between these two vascular diseases is discussed. Different risk factors are common in both diseases, such as dyslipidaemia, metabolic syndrome, and thrombophilia. Etiopathogenetic mechanisms of both diseases are similar. Inflammation, as a basic pathogenetic mechanism of arterial atherosclerosis, is also involved in the pathogenesis of VTE. Inflammation as a response to vessel wall injury promotes coagulation and inhibits endogenic fibrinolytic activity, which results in thromboembolic events in the arterial as well as in the venous system. A relationship has also been observed between preclinical or clinical arterial atherosclerosis and VTE. These findings indicate that atherosclerosis may induce VTE or that common risk factors simultaneously stimulate the development of both diseases. The relationship between arterial and venous disease is also supported by the efficacy of some drugs (antiplatelets, anticoagulants, statins) in the prevention of both diseases. In conclusion, arterial and venous diseases share similar pathophysiological mechanisms, often driven by common risk factors. This overlap suggests that a unified approach to prevention and treatment may be beneficial for both conditions, potentially improving patient outcomes by addressing the underlying shared pathways.
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