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World J Cardiol. Apr 26, 2023; 15(4): 142-153
Published online Apr 26, 2023. doi: 10.4330/wjc.v15.i4.142
Optimization of the pharmacological therapy in patients with poly-vascular disease: A multidisciplinary approach
Rocco Gioscia, Claudio Castagno, Monica Verdoia, Barbara Conti, Enzo Forliti, Andrea Rognoni
Rocco Gioscia, Monica Verdoia, Andrea Rognoni, Department of Cardiology, Nuovo Ospedale Degli Infermi, Biella 13900, Italy
Claudio Castagno, Barbara Conti, Enzo Forliti, Department of Vascular Surgery, Nuovo Ospedale Degli Infermi, Biella 13900, Italy
Author contributions: Gioscia R, Castagno C, and Verdoia M contributed to manuscript writing and data collection; Conti B, Forliti E, and Rognoni A contributed to scientific revision; All authors have approved the final draft of the manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrea Rognoni, MD, Chief Physician, Department of Cardiology, Nuovo Ospedale Degli Infermi, via dei Ponderanesi, Biella 13900, Italy. andrea.rognoni@aslbi.piemonte.it
Received: January 3, 2023
Peer-review started: January 3, 2023
First decision: March 15, 2023
Revised: March 27, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: April 26, 2023
Processing time: 106 Days and 21.3 Hours
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.