ABSTRACT NUMBER: ESOC2026A2194 CEREBROVASCULAR DISEASES AND MULTIFOCAL ATHEROSCLEROSIS: PATHOPHYSIOLOGICAL LINKS AND CLINICAL IMPLICATIONS

Abstract Background and aims Cerebrovascular diseases remain a leading cause of mortality and disability and are increasingly observed in working-age populations. Multifocal atherosclerosis affecting coronary, carotid, and other major arteries plays a key role in the development of stroke and myocardial infarction. Growing evidence indicates that vascular calcification, bone metabolism disorders, inflammation, and endothelial dysfunction are interconnected processes contributing to cerebrovascular pathology. Methods This study is a narrative review of clinical and experimental data addressing the relationship between cerebrovascular diseases and multifocal atherosclerosis. The analysis focused on shared pathophysiological mechanisms, including endothelial dysfunction, oxidative stress, inflammation, vascular calcification, and disturbances in calcium–phosphorus metabolism, as well as the role of regulatory molecules involved in vascular and bone remodeling. Results Multifocal atherosclerosis represents the advanced stage of a generalized atherosclerotic process and is frequently associated with hemodynamically significant arterial stenosis and thromboembolic complications leading to stroke and myocardial infarction. Vascular calcification was identified as an active, regulated process sharing common molecular pathways with bone metabolism, including osteoprotegerin, RANKL, osteopontin, inflammatory cytokines, and vitamin D–dependent mechanisms. Clinical observations demonstrate a frequent coexistence of cardiovascular pathology and reduced bone mineral density, supporting the concept of shared pathophysiological mechanisms underlying cerebrovascular disease and systemic atherosclerosis. Conclusions Cerebrovascular diseases and multifocal atherosclerosis are closely linked through shared mechanisms of vascular inflammation, calcification, and metabolic dysregulation.The interaction between vascular pathology and bone metabolism highlights the systemic nature of atherosclerosis and its complications.Understanding these interconnected processes may improve early risk identification and support integrated preventive strategies aimed at reducing stroke-related morbidity and mortality. Conflict of interest Nothing to disclose