Correlation between Coronary Artery Disease with Other Arterial Systems: Similar, Albeit Separate, Underlying Pathophysiologic Mechanisms

Abstract

Atherosclerosis is a multifactorial systemic disease that affects the entire arterial tree, although some areas are more prone to lipid deposits than others. Moreover, the histopathological composition of the plaques differs, and the clinical manifestations are also different, depending on the location and structure of the atherosclerotic plaque. Some arterial systems are correlated with each other more than in that they simply share a common atherosclerotic risk. The aim of this perspective review is to discuss this heterogeneity of atherosclerotic impairment in different arterial districts and to investigate the current evidence that resulted from studies of the topographical interrelations of atherosclerosis.

Lessons from autopsy: Topographical variability of atherosclerosis plaques

“…These findings collectively confirm previous studies that have highlighted the marked heterogeneity of atherosclerotic involvement across various arterial districts. 1 , 17 , 18 , 22 In our case, the aorta was the vascular district predominantly affected by the atherosclerotic process, while the carotids showed only mild involvement. Furthermore, significant inter-plaque variability was observed in this study, even within the same vascular district.…”

“…Previous research has associated this heterogeneity with the location of the plaques. 18 Specifically, coronary plaques have been suggested to differ from plaques found in peripheral arterial systems. 17 This discrepancy is partially attributed to the distinctive geometry of coronary arteries, which influences the architecture and cellular composition of coronary plaques compared to those in other vascular districts.…”

“… 14 – 16 Differences in plaque histology among different vascular systems suggest unique pathophysiological mechanisms at play, potentially influencing plaque structural characteristics. 17 , 18 Studies have revealed variations in plaque histology based on their location, implying that local characteristics unique to specific areas of the vascular tree may impact the development of more stable or more vulnerable plaques. In the setting of carotid and coronary atherosclerosis, the following elementary lesions have been identified as possible differential markers between stable and unstable atherosclerotic plaques: plaque erosion, fibrous cap thickness, macrophage accumulation inside the fibrous cap, lipid-rich necrotic core dimensions.…”

Chinese expert consensus on anti-thrombotic therapy for pan-vascular diseases (2023 edition)

“…Although atherosclerosis is the common pathological basis of pan-vascular diseases, differences in hemodynamics (such as blood flow velocity and shear forces) exist among plaque sites in different vascular beds, leading to variations in the progression of different vascular bed diseases [28] . Approximately 2% to 14% of patients with coronary artery atherosclerosis have concurrent carotid artery lesions, while about one third of patients with severe carotid artery stenosis also have significant coronary artery stenosis [29] . Atherosclerotic plaques in the superficial femoral artery typically occur later than those in the coronary and carotid arteries.…”

Socratic lectures 10 - Part I

“…Among them, ten studies provided data on the total glycome of milk or tissue samples, while many others analyzed glycosylation of individual proteins, with fetuin being the most frequently studied (Beletić et al, 2023a). Apart from the associated (patho)biological relevance, which is still challenging, bovine fetuin is also worth mentioning in the analytical context as a frequent testing analyte during the development of glycoproteomics analytical approaches (Achim et al, 2023). Milk-related studies brought the data about total glycome, or individual proteins, like casein or IgG (Beletić et al, 2023a), which are of particular relevance in the assessment of milk quality and nutritive value (O'Riordan et al, 2014).…”