Comprehensive insights into peripheral artery disease: an overview from the working groups of pathogenesis of atherosclerosis and thrombosis of the Italian Society of Cardiology

Peripheral artery disease (PAD) is a global health burden due to its high prevalence, morbidity, and mortality. It affects more than 200 million people worldwide. PAD is a manifestation of systemic atherosclerosis that is often associated with coronary and cerebrovascular disease, underscoring its crucial role as an indicator of advanced vascular pathology. Despite its strong association with cardiovascular morbidity, PAD remains underdiagnosed and undertreated compared with coronary artery disease (CAD), highlighting a significant gap in care. Patients with PAD are at increased risk of myocardial infarction (MI), stroke, and limb amputation, so a multidisciplinary approach is required to reduce adverse outcomes. Identifying at-risk patients through early screening and implementing evidence-based therapeutic strategies is crucial in treating PAD. Modern lipid-lowering agents, dual antithrombotic therapies, and aggressive risk factor control are essential treatment components. Recent advances, including PCSK9 inhibitors and novel antiplatelet agents, have shown promise for improving cardiovascular and limb-related outcomes, although further validation is needed. Given the systemic nature of atherosclerosis, managing PAD should be a cornerstone of cardiovascular care, requiring individualised treatment plans. Increasing awareness and understanding of PAD is critical to bridging gaps in diagnosis and treatment to improve the overall prognosis and quality of life of patients with this debilitating disease. This work aims to enhance practical approaches to PAD by providing comprehensive insights into its management and offering a foundation for exploring innovative future treatment options.