Optimization of the pharmacological therapy in patients with poly-vascular disease: A multidisciplinary approach

Abstract

The recent shift of the concept of cardiovascular disease as a chronic progressive condition, potentially involving multiple districts, has driven attention to the optimal management of patients with concomitant coronary and peripheral artery disease, representing a subset of patients with an increased risk of events and impaired survival. Recent pharmacological achievements in terms of antithrombotic therapy and lipid-lowering drugs allow multiple therapeutical combinations, thus requiring optimizing the treatment in a tailored fashion according to patients’ risk profiles. Nevertheless, data dedicated to this specific subset of patients are still modest. We summarize currently available strategies and indications for the management of antithrombotic and lipid-lowering drugs in patients with the poly-vascular disease.

Keywords: Poly-vascular disease, Coronary artery disease, Atherosclerosis, Antitrombotic therapy, Cholesterol, Statins, PCSK9

Core Tip: Patients with concomitant coronary and peripheral artery disease, i.e. poly-vascular disease, represent a subset of patients with higher risk and worse prognosis. In these patients antithrombotic and antilipidemic drugs should be tailored in order to achieve the most aggressive combination tolerated for each patient. Multidisciplinary approach, involving both a cardiologist and vascular surgeon, combining different therapeutic goals and perspectives, could provide additional benefits in the correct management of poly-vascular patients.