Acute Coronary Syndrome: Disparities of Pathophysiology and Mortality with and without Peripheral Artery Disease.
Flavius-Alexandru GherasieMihaela Roxana PopescuDaniela BartosPublished in: Journal of personalized medicine (2023)
There are a number of devastating complications associated with peripheral artery disease, including limb amputations and acute limb ischemia. Despite the overlap, atherosclerotic diseases have distinct causes that need to be differentiated and managed appropriately. In coronary atherosclerosis, thrombosis is often precipitated by rupture or erosion of fibrous caps around atheromatous plaques, which leads to acute coronary syndrome. Regardless of the extent of atherosclerosis, peripheral artery disease manifests itself as thrombosis. Two-thirds of patients with acute limb ischemia have thrombi associated with insignificant atherosclerosis. A local thrombogenic or remotely embolic basis of critical limb ischemia may be explained by obliterative thrombi in peripheral arteries of patients without coronary artery-like lesions. Studies showed that thrombosis of the above-knee arteries was more commonly due to calcified nodules, which are the least common cause of luminal thrombosis associated with acute coronary events in patients with acute coronary syndrome. Cardiovascular mortality was higher in peripheral artery disease without myocardial infarction/stroke than in myocardial infarction/stroke without peripheral artery disease. The aim of this paper is to gather published data regarding the disparities of acute coronary syndrome with and without peripheral artery disease in terms of pathophysiology and mortality.
Keyphrases
- peripheral artery disease
- acute coronary syndrome
- coronary artery
- pulmonary embolism
- percutaneous coronary intervention
- cardiovascular events
- coronary artery disease
- antiplatelet therapy
- cardiovascular disease
- liver failure
- end stage renal disease
- risk factors
- atrial fibrillation
- pulmonary artery
- heart failure
- chronic kidney disease
- respiratory failure
- ejection fraction
- left ventricular
- total knee arthroplasty
- healthcare
- peritoneal dialysis
- drug induced
- aortic stenosis
- electronic health record
- intensive care unit
- prognostic factors
- aortic dissection
- transcatheter aortic valve replacement
- affordable care act
- big data
- pulmonary arterial hypertension
- data analysis