Moving vessel wall research beyond the plaque: Basilar artery dilation as a window to systemic cardiovascular events

摘要

The overlap between atherosclerotic disease of the cere-brovascular, cardiovascular, and peripheral vasculature has long been recognized. Carotid atherosclerosis increases the odds of coronary events and of finding atherosclerotic changes in coronary, cerebral, aortic, and iliac arteries. Similarly, peripheral vascular disease is a risk factor for both stroke and myocardial infarction and is associated with extra-cranial carotid and intracranial atherosclerosis. Data from the Reduction of Atherothrombosis for Continued Health (REACH) registry show that atherosclerosis in 1 vascular bed increases the risk of adverse outcomes in each of the other locations, and that multiple disease locations at baseline increase the risk of subsequent cardiovascular and cerebrovas-cular events. Given shared underlying risk factors and patho-physiology, it is not surprising that those who present with atherosclerotic disease in 1 vascular bed are at increased risk for disease in others.