The clinical symptoms of ATS are the “late” results of a slowly-progressing inflammatory process, that
has began a long time before. "Preclinical ATS" is an early stage of this process and is characterized by minimal
damage, potentially susceptible to correction. Furthermore, pre-clinical ATS (assessed by using multiple
described approaches) involves a multifocal disease. For example, IMT is associated to the detection of
endothelial dysfunction, to the coronary and peripheral atherosclerotic manifestations. The early carotid
involvement (in spite of the slow development of lesions in other peripheral arteries) is probably due to the
characteristics of the carotid flow. A reduced ABI is independently related to the presence of increased IMT and
multifocal ATS. Then, it is a marker of both coronary and carotid ATS. The reduction of FMD is an “index of
extension” of CAD (i.e.: one, two or three vessel involved) at the coronary angiography. A FMD lower or equal
to 4.5% is a valid marker of CAD.
Keywords: Slowly-progressive inflammatory process, preclinical atherosclerosis, multifocal atherosclerosis,
relationship between peripheral and coronary artery disease
