Recent Progress in Diagnosis and Treatment of Atherosclerosis as a Polyvascular Disease

  Atherothrombosis is the leading cause of death in the world. It is expected that morbidity of atherothrombosis increases in Japan with westernization of eating behavior, insufficient physical activity, and aging society. Atherothrombosis has been recognized in relation to organ damage, such as coronary artery disease (CAD), cerebrovascular disease (CVD), and peripheral artery disease (PAD). Recently, atherothrombosis is recognized as a polyvascular disease, since atherosclerotic diseases progress in different arteries in one patient. According to REACH registry, 10.6% of CAD patients had PAD and 51.6% of PAD patients had CAD. Polyvascular disease with multiple locations was the most powerful predictor of future ischemic events. Therefore, it is important to manage atherosclerosis as a systemic polyvascular disease as well as local therapy such as PCI.
  Moreover, the concept, polyvascular disease, is important in the treatment of acute coronary syndrome (ACS). It is well known that most of the ACS results from abrupt thrombotic occlusion of mildly-stenotic lesion. Prediction of ACS is difficult, as there is no way to detect vulnerable plaque. Therefore, it is important to diagnose polyvascular disease using non-invasive vascular function tests and to start treating it at earlier stage.
  In this symposium, we will have presentations about recent progress in diagnosis and treatment of polyvascular disease. We will discuss about future clinical approach against polyvascular disease.