Chronic Coronary Artery Disease

Atherosclerosis is a chronic arterial disease and represents the first leading cause of vascular disease worldwide [1]. In addition, forecast estimated that by 2020 cardiovascular diseases, especially atherosclerosis, will become the most widespread diseases in the world [2]. Atherosclerosis is at the basis of the most frequent cardiovascular disease: chronic ischemic heart disease (CIHD) [3]. In Europe (WHO data 2014), CIHD is responsible for almost half (46%) of all deaths (30% in individuals <65 years old and 37% in those <75 years old) [4]. Atherogenesis (i.e. the formation of atheromatic plaques) takes place at the endothelium level, involving arteries of the all human body and their growth lasts for decades [5]. After a silent and prolonged period, the atherosclerotic plaque tends to cause the obstruction to the passage of blood downstream the stenosis (a process called ischemia) either by a reduction in lumen vessel’s size (chronic process) or by the rupture of the plaque itself with consequent embolization of atherogenic material (acute process) and subsequent acute ischemia, in most cases [6]. If different arteries of our body are affected, the signs and symptoms of atherosclerosis will depend on the affected sites; more frequently, atheromasic plaques are formed at the level of coronary arteries whose principal symptom is represented by chest pain (“angina”); if plaques involve carotid arteries the main manifestation will be a transient ischemic attack (TIA) or a cerebral stroke; finally if plaque forms at peripheral arteries’ level, patients will experience pain during the march (“claudicatio intermittens”) [6].