What is meant by the concept of vascular protection?
Vascular protection is a comprehensive strategy aimed at preventing potentially fatal ischaemic events, such as myocardial infarction (MI) and stroke, in patients with cardiovascular (CV) disease due to atherosclerosis. Ischaemic events are typically precipitated by atherothrombosis, the formation of platelet- and fibrin-rich arterial thrombi on the vascular wall at the site of atherosclerotic plaque rupture (or erosion).1,2
There are several key elements of vascular protection:3,4
- CV risk factor control through lifestyle changes
- Medical therapies to limit atherosclerosis progression and stabilize existing plaques, making them less prone to rupture/erosion
- Antithrombotic therapies (e.g. with single antiplatelet therapy in patients with stable CV disease) to prevent blood clot formation over any ruptured/eroded atherosclerotic plaques
These elements are summarized in the figure below:
Patients who have had an ischaemic event remain at increased CV risk indefinitely, so it is essential that all elements of a vascular protection strategy are evaluated to ensure that patients are optimally managed. Adjustment of secondary prevention strategies might include intensifying antithrombotic therapy for patients judged at high risk, or using newer medications to improve management of blood pressure, lipid-lowering or glucose control.4