Atherosclerotic Burden and Mortality

Abstract:

Cardiovascular diseases are the main cause of death in developed countries, in spite of the fact that cardiovascular disease rates and case-fatality rates have fallen considerably over the last two decades in these countries. Atherosclerosis is the leading cause of cardiovascular diseases, and can remain asymptomatic for many years, with sudden death often being its first clinical manifestation. Atherosclerosis represents a grave health problem, it increases mortality, is associated with a poor prognosis, and significantly reduces life expectancy. Atherosclerotic burden is a concept that has gained considerable interest due to the fact that it is a powerful predictor of new cardiovascular events and is related to poor outcome after cardiovascular events. There are several well documented methods to evaluate and quantify the atherosclerotic burden, resting ankle-brachial index, carotid intima-media thickness, ultrasound-based endothelial function, and high-sensitivity testing for C – Reactive Protein being the most widely used. Other current methods used to identify high-risk people are assessment using some scores such as Framingham risk scoring. The impact of some cardiovascular risk factors on global and cardiovascular mortality is evident, mainly for arterial hypertension and diabetes. The addition of cardiovascular risk factors is associated with an increased risk of cardiovascular events, as well as early mortality after cardiovascular events. Moreover, multiple disease locations increased the risk of cardiovascular events as well as mortality compared with patients having multiple risk factors only, peripheral arterial disease patients being those with the highest cardiovascular mortality rate. Atherosclerosis should be considered as a global disease and, as a consequence, studied globally. Identification and quantification of global atherosclerotic burden is a useful tool to identify those patients at high risk of cardiovascular events or cardiovascular death.