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Peer-reviewedCC BYMedicina (Kaunas, Lithuania)

PAD as a Marker of Systemic Atherosclerosis: A Comprehensive Review of Residual Risk and Contemporary Strategies for MACE and MALE Reduction.

  • Giuseppe Miceli1,2
  • Maria Grazia Basso1,2
  • Mariagiovanna Cuffaro1,2
  • Antonino Marchese1,2
  • Antonino Tuttolomondo1,2
  1. 1Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities (ProMISE), Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy.
  2. 2Internal Medicine and Stroke Care Ward. University Hospital, Policlinico "P. Giaccone", Piazza delle Cliniche 2, 90127 Palermo, Italy.
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Abstract

Background: Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis associated with substantial risks of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Scope: This comprehensive review examines the epidemiological and pathobiological links between PAD, polyvascular disease, and residual cardiovascular and limb risk. Evidence Synthesis: It summarizes contemporary evidence for integrated management through antithrombotic therapy, intensive lipid lowering, blood pressure and diabetes management, smoking cessation, structured exercise, revascularization when indicated, and longitudinal surveillance. Particular attention is given to dual-pathway inhibition, non-statin lipid-lowering agents, and cardiometabolic therapies, while distinguishing established PAD-specific benefits from subgroup or emerging evidence. Conclusions: A phenotype-based approach integrating ischemic, bleeding, metabolic, functional, and limb-related risk is proposed to support individualized treatment and sustained vascular protection.

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Cite

BibTeXRIS
BibTeX
@article{miceli2026marker,
  title = {{PAD as a Marker of Systemic Atherosclerosis: A Comprehensive Review of Residual Risk and Contemporary Strategies for MACE and MALE Reduction.}},
  author = {Giuseppe Miceli and Maria Grazia Basso and Mariagiovanna Cuffaro and Antonino Marchese and Antonino Tuttolomondo},
  journal = {Medicina (Kaunas, Lithuania)},
  year = {2026},
  month = oct,
  doi = {10.3390/medicina62101905},
  url = {https://europepmc.org/article/MED/42942436},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - PAD as a Marker of Systemic Atherosclerosis: A Comprehensive Review of Residual Risk and Contemporary Strategies for MACE and MALE Reduction.
AU  - Giuseppe Miceli
AU  - Maria Grazia Basso
AU  - Mariagiovanna Cuffaro
AU  - Antonino Marchese
AU  - Antonino Tuttolomondo
PY  - 2026
DA  - 2026/10/02
JO  - Medicina (Kaunas, Lithuania)
DO  - 10.3390/medicina62101905
UR  - https://europepmc.org/article/MED/42942436
AB  - Background: Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis associated with substantial risks of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Scope: This comprehensive review examines the epidemiological and pathobiological links between PAD, polyvascular disease, and residual cardiovascular and limb risk. Evidence Synthesis: It summarizes contemporary evidence for integrated management through antithrombotic therapy, intensive lipid lowering, blood pressure and diabetes management, smoking cessation, structured exercise, revascularization when indicated, and longitudinal surveillance. Particular attention is given to dual-pathway inhibition, non-statin lipid-lowering agents, and cardiometabolic therapies, while distinguishing established PAD-specific benefits from subgroup or emerging evidence. Conclusions: A phenotype-based approach integrating ischemic, bleeding, metabolic, functional, and limb-related risk is proposed to support individualized treatment and sustained vascular protection.
SN  - 1010-660X
SN  - 1648-9144
ER  -