TY - JOUR
T1 - Coronary Artery Calcification
T2 - Current Concepts and Clinical Implications
AU - Onnis, Carlotta
AU - Virmani, Renu
AU - Kawai, Kenji
AU - Nardi, Valentina
AU - Lerman, Amir
AU - Cademartiri, Filippo
AU - Scicolone, Roberta
AU - Boi, Alberto
AU - Congiu, Terenzio
AU - Faa, Gavino
AU - Libby, Peter
AU - Saba, Luca
N1 - Publisher Copyright:
© 2024 American Heart Association, Inc.
PY - 2024/1/16
Y1 - 2024/1/16
N2 - Coronary artery calcification accompanies the development of advanced atherosclerosis. Its role in atherosclerosis holds great interest because the presence and burden of coronary calcification provide direct evidence of the presence and extent of coronary artery disease; furthermore, CAC predicts future events independently of concomitant conventional cardiovascular risk factors and to a greater extent than any other noninvasive biomarker of this disease. Nevertheless, the relationship between CAC and the susceptibility of a plaque to provoke a thrombotic event remains incompletely understood. This review summarizes the current understanding and literature on CAC. It outlines the pathophysiology of CAC and reviews laboratory, histopathological, and genetic studies, as well as imaging findings, to characterize different types of calcification and to elucidate their implications. Some patterns of calcification such as microcalcification portend increased risk of rupture and cardiovascular events and may improve prognosis assessment noninvasively. However, contemporary computed tomography cannot assess early microcalcification. Limited spatial resolution and blooming artifacts may hinder estimation of degree of coronary artery stenosis. Technical advances such as photon counting detectors and combination with nuclear approaches (eg, NaF imaging) promise to improve the performance of cardiac computed tomography. These innovations may speed achieving the ultimate goal of providing noninvasively specific and clinically actionable information.
AB - Coronary artery calcification accompanies the development of advanced atherosclerosis. Its role in atherosclerosis holds great interest because the presence and burden of coronary calcification provide direct evidence of the presence and extent of coronary artery disease; furthermore, CAC predicts future events independently of concomitant conventional cardiovascular risk factors and to a greater extent than any other noninvasive biomarker of this disease. Nevertheless, the relationship between CAC and the susceptibility of a plaque to provoke a thrombotic event remains incompletely understood. This review summarizes the current understanding and literature on CAC. It outlines the pathophysiology of CAC and reviews laboratory, histopathological, and genetic studies, as well as imaging findings, to characterize different types of calcification and to elucidate their implications. Some patterns of calcification such as microcalcification portend increased risk of rupture and cardiovascular events and may improve prognosis assessment noninvasively. However, contemporary computed tomography cannot assess early microcalcification. Limited spatial resolution and blooming artifacts may hinder estimation of degree of coronary artery stenosis. Technical advances such as photon counting detectors and combination with nuclear approaches (eg, NaF imaging) promise to improve the performance of cardiac computed tomography. These innovations may speed achieving the ultimate goal of providing noninvasively specific and clinically actionable information.
KW - atherosclerosis
KW - calcinosis
KW - cardiac imaging techniques
KW - coronary angiography
KW - coronary vessels
KW - plaque, atherosclerotic
KW - vascular calcification
UR - http://www.scopus.com/inward/record.url?scp=85182273815&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85182273815&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.123.065657
DO - 10.1161/CIRCULATIONAHA.123.065657
M3 - Review article
C2 - 38227718
AN - SCOPUS:85182273815
SN - 0009-7322
VL - 149
SP - 251
EP - 266
JO - Circulation
JF - Circulation
IS - 3
ER -