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Volume 15
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10.3390/life15081226
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Review

Coronary Artery Disease and Atherosclerosis in Other Vascular Districts: Epidemiology, Risk Factors and Atherosclerotic Plaque Features

by
Michele Russo
1,2,3,*,
Filippo Luca Gurgoglione
4,*,
Alessandro Russo
5,
Riccardo Rinaldi
6,
Laura Torlai Triglia
4,
Matteo Foschi
7,
Carlo Vigna
5,
Rocco Vergallo
8,9,
Rocco Antonio Montone
10,11,
Umberto Benedetto
12,
Giampaolo Niccoli
4 and
Marco Zimarino
1,13
1
Department of Cardiology, SS. Annunziata Hospital, ASL2 Abruzzo, 66100 Chieti, Italy
2
Department of Cardiology, F. Renzetti Hospital, ASL2 Abruzzo, 66034 Lanciano, Italy
3
Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, 31015 Conegliano, Italy
4
Department of Medicine, University of Parma, 43125 Parma, Italy
5
Cardiology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
6
Cardiology Unit, Infermi Hospital, 47923 Rimini, Italy
7
Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy
8
Interventional Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
9
Department of Internal Medicine and Medical Specialties (DIMI), Università di Genova, 16132 Genova, Italy
10
Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy
11
Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
12
Department of Cardiac Surgery, University “G. d’Annunzio”, 66100 Chieti, Italy
13
Department of Neuroscience, Imaging and Clinical Sciences, “Gabriele d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
 
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*
Authors to whom correspondence should be addressed.
Life 2025, 15(8), 1226; https://doi.org/10.3390/life15081226 (registering DOI)
Submission received: 27 May 2025 / Revised: 27 July 2025 / Accepted: 31 July 2025 / Published: 3 August 2025
(This article belongs to the Special Issue Coronary Artery Disease: Pathophysiological Mechanisms, Imaging Modalities and Therapeutic Implications)
Versions Notes

Abstract

Coronary artery disease (CAD) is the main cause of morbidity and death worldwide, and atherosclerosis represents the leading pathophysiological pathway responsible for CAD. Atherosclerotic process is a complex interplay of mechanisms and mediators resulting in plaque formation, progression and destabilization, the latter being the most frequent cause of acute cardiovascular events. Considering the systemic nature of atherosclerosis, polyvascular disease involvement is possible and has been described since 1960s. Accordingly, epidemiologic studies reported that concomitant CAD and atherosclerosis in other arterial beds like carotid arteries, lower limb arteries, mesenteric and renal circulation, and aorta, is frequent and related to increased chance of future cardiovascular events. Although risk factors, atherosclerotic plaque features and mechanisms of plaque destabilization are largely shared across different sites, many studies have reported some disparities among districts. Moreover, simultaneous polyvascular disease has been associated with increased likelihood of having particular plaque characteristics depending on the affected arterial level. In this comprehensive narrative review, we aim to discuss about epidemiology of concomitant CAD and atherosclerosis in other arterial beds, and to examine differences in risk factors, plaque features and mechanisms of plaque instability between CAD and other atherosclerotic locations. Finally, we review the studies observing differences on plaque features according to involved atherosclerotic sites, focusing on CAD.
Keywords: coronary artery disease; atherosclerosis; polyvascular disease; risk factors; plaque features; plaque destabilization. coronary artery disease; atherosclerosis; polyvascular disease; risk factors; plaque features; plaque destabilization.

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MDPI and ACS Style

Russo, M.; Gurgoglione, F.L.; Russo, A.; Rinaldi, R.; Torlai Triglia, L.; Foschi, M.; Vigna, C.; Vergallo, R.; Montone, R.A.; Benedetto, U.; et al. Coronary Artery Disease and Atherosclerosis in Other Vascular Districts: Epidemiology, Risk Factors and Atherosclerotic Plaque Features. Life 2025, 15, 1226. https://doi.org/10.3390/life15081226

AMA Style

Russo M, Gurgoglione FL, Russo A, Rinaldi R, Torlai Triglia L, Foschi M, Vigna C, Vergallo R, Montone RA, Benedetto U, et al. Coronary Artery Disease and Atherosclerosis in Other Vascular Districts: Epidemiology, Risk Factors and Atherosclerotic Plaque Features. Life. 2025; 15(8):1226. https://doi.org/10.3390/life15081226

Chicago/Turabian Style

Russo, Michele, Filippo Luca Gurgoglione, Alessandro Russo, Riccardo Rinaldi, Laura Torlai Triglia, Matteo Foschi, Carlo Vigna, Rocco Vergallo, Rocco Antonio Montone, Umberto Benedetto, and et al. 2025. "Coronary Artery Disease and Atherosclerosis in Other Vascular Districts: Epidemiology, Risk Factors and Atherosclerotic Plaque Features" Life 15, no. 8: 1226. https://doi.org/10.3390/life15081226

APA Style

Russo, M., Gurgoglione, F. L., Russo, A., Rinaldi, R., Torlai Triglia, L., Foschi, M., Vigna, C., Vergallo, R., Montone, R. A., Benedetto, U., Niccoli, G., & Zimarino, M. (2025). Coronary Artery Disease and Atherosclerosis in Other Vascular Districts: Epidemiology, Risk Factors and Atherosclerotic Plaque Features. Life, 15(8), 1226. https://doi.org/10.3390/life15081226

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