Clinical manifestations of atherosclerosis

Abstract

Cardiovascular disease (CVD) accounts for more than 4.3 million deaths in Europe representing 48% of all deaths (British Heart Foundation. European Cardiovascular Disease Statistics 2008) and is predicted to be the number one killer by 2020 in our ageing societies facing major societal and economic changes around the globe [1]. The clinical manifestations of CVD are diverse and comprise myocardial infarction, stroke, aortic aneurysms, renal artery stenosis and gangrene (Fig. 3.1). In Europe, the single most common cause of death is coronary artery disease (CAD; 21% of men and 21% of women) followed by stroke (11% of men and 17% of women) and the remaining manifestations of CVD (11% of men and 15% of women) (British Heart Foundation. European Cardiovascular Disease Statistics 2008). Despite major reductions in mortality obtained in the setting of acute myocardial infarction [2], morbidity due to CVD remains of eminent importance across the world as quantified with the Disability Adjusted Life Years (DALY) as an aggregate of years of life lost to due to premature death and years of healthy life lost to disability (British Heart Foundation. European Cardiovascular Disease Statistics 2008). Currently, 70% of clinical events cannot be prevented with available drug therapy including statins [3] and at least 10% of coronary events occur in apparently healthy individuals in the absence of major traditional risk factors [4].