Polyvaskuläre Atherosklerose: Prävalenz und Prognose

Polyvaskuläre Erkrankungen sind eine schwere, generalisierte Form atherosklerotischer Erkrankungen. Sie werden im klinischen Alltag oft nicht berücksichtigt, wenngleich sie sich durch eine der höchsten kardiovaskulären Ereignis- und Mortalitätsraten auszeichnen. Die Entwicklung, Häufigkeit und Auswirkung dieser schwersten Form der Atherosklerose wird in diesem Übersichtsartikel abgehandelt.

Abstract

Polyvascular diseases are a severe, generalized form of atherosclerotic disease. They are often overlooked in routine clinical practice, despite being characterized by one of the highest cardiovascular event and mortality rates. Registry studies (e.g., REACH) recognized and investigated the severity of the disease early on. Randomized trials specifically designed for polyvascular diseases are needed in the future, especially with a view to adapting therapy accordingly. Until appropriate adaptations are scientifically supported, polyvascular patients should be identified and, if necessary, treated more strictly regarding their risk constellation.

Kernaussagen

• Die polyvaskuläre Erkrankung ist die generalisierte Form der Atherosklerose, bestehend aus KHK, pAVK und cAVK – auch atherosklerotische Erkrankungen der Nierenarterien und der Aorta gehören dazu.

• pAVK-Patienten weisen das höchste Risko für das Vorliegen bzw. die zukünftige Entwicklung einer polyvaskulären Erkrankung auf.

• Die polyvaskuläre Erkrankung zeichnet sich durch eine hohe kardiovaskuläre Ereignisrate (MACE/MALE) und Mortalität aus.

• Ein zeitgleich bestehender Diabetes mellitus ist nicht nur als Risikofaktor anzusehen, sondern auch als aggravierender Ko-Faktor für MACE/MALE und Mortalität.

• Ein Screening auf eine polyvaskuläre Erkrankung ist vor Herz- und Gefäß-Operationen zu empfehlen.

Schlüsselwörter

polyvaskuläre Erkrankungen - periphere arterielle - koronare Herzerkrankung - Verschlusskrankheit - zerebrovaskulär - Mortalitätsrate - Ereignisrate - kardiovaskulär

Keywords

polyvascular disease - peripheral artery disease - coronary artery disease - cerebrovascular disease - mortality - event rate - cardiovascular

Publication History

Article published online:
28 May 2025

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