Multifocal vascular affection in a patient with angina pectoris - rationale and design of a clinical study

Atherosclerosis is a disease of the large and middle arteries and is characterized mainly by endothelial dysfunction, inflammation of the vascular wall and the accumulation of lipids, cholesterol, calcium and cell debris in the intima of the vascular wall. This accumulation leads to plaque formation, vascular remodeling, acute and chronic obstruction of the vessel lumen, blood flow abnormalities, and reduced oxygen supply to target organs. As a result, blood vessels become harder and their lumen shrinks, which increases the risk of obstruction and thrombosis. Depending on the affected area, the corresponding symptoms appear - angina or myocardial infarction when affecting the coronary circulation; transient ischemic attack (TIA) or stroke affecting cerebral circulation; claudication or gangrene when affecting the limbs; aneurysm or dissection affecting the aorta. Various risk factors are known to affect the onset of the disease. They are divided into adjustable (dyslipoproteinemia, hypertension, diabetes mellitus, smoking, obesity, inactivity, emotional stress, etc.) and unadjustable (gender, age, family predisposition). The risk of developing atherosclerosis increases significantly in the presence of several risk factors. For example, the presence of 2 risk factors increases the risk of developing atherosclerosis 4 times. The atherosclerotic process is multifocal - it develops everywhere in the body - affecting the cardiac, cerebral and peripheral arteries almost simultaneously or sequentially. Its isolated manifestations in only one area are an exception.