1. STROKE STATS Third leading cause of death 160 000 deaths a year 731 000 strokes a year 4 400 000 stroke survivors Leading cause of adult disability Source: Stroke Facts: 1999 NSA

2. Prevalence of stroke by age and sex United States: 1988-94 Heart Disease and Stroke Statistics – 2003 Update. Dallas, TX: AHA; 2002.

3. Adult Treatment Panel II National Cholesterol Education Program Circulation 1994; 89:1333-1435 Kannel WB. J. Cardiovascular Risk 1994; 1:333-339 Wilterdink et al., Arch Neurol 1992;49:857-863 Criqui et al., N. Engl. J. Med. 1992; 326:381-386 Initial event Increase in risk MI Stroke Myocardial infarction 5 - 7 times (includes death) 3 - 4 times ( includes TIA) Ischemic stroke 2 - 3 times (includes angina and sudden death) 9 times PAD 4 times (includes fatal MI & other CHD death) 2 - 3 times ( includes TIA) Peripheral vascular Cerebrovascular Coronary artery

4. Long-term risk of a cardiovascular event following a TIA Clark et al. J Neurol Neurosurg Psychiatry 2003;74:577-580 CV death, MI or stroke CHD death or MI Any stroke

5. Prevalence of IVUS-detected atherosclerotic coronary artery disease 21% 66% 75% 85% 91% 0 20 40 60 80 100 13-1920-2930-39 40-49 >50 Prevalence (%) 262 healthy donor heart transplants Tuzcu EM. Circulation 2001;103:2705 Age (years)

6. 68% 18% 14% 0 200 0 100 Pre-MI Stenosis >70% 50-70% < 50% # patients Ambrose 1985 Little 1988 Nobuyoshi 1991 Giroud 1992 All E Falk, PK Shah, V Fuster. Circulation 1995;92:657 Stenosis severity by angiography of atherosclerotic disease preceding MI

7. Clinical presentation of atherosclerosis: Just the tip of the iceberg Clinical atherosclerosis CAD CVAPAD Subclinical Hyperinsulinemia Dyslipidemia Inflammation Platelet activation Hypercoagulable Endothelial dysfunction Oxidative stress