Structured Graphical Abstract.

The hypothesis of the natural history of the inflammatory process involving the atherosclerotic plaque formation. Bone marrow (BM) is implicated in the atherosclerotic process long before the appearance of acute cardiovascular events. Cardiovascular risk factors trigger BM activation, initially in the absence of systemic inflammation. As BM activation progresses, it is accompanied by an increase in haematopoietic progenitor cells and an associated increase in inflammatory markers. The next step in the process is arterial inflammation, leading to an increase in atherosclerotic burden.