[Coronary calcification. Physiopathology, clinical significance, and new diagnostic-therapeutic prospects]
Related Experiment Video
Updated: Sep 28, 2026
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
1Divisione Clinica Medica III, Dipartimento di Medicina Clinica, Policlinico Umberto I, Università La Sapienza, Roma. marcofalc@libero.it
Insights
Coronary calcium scoring can identify individuals at risk for heart events, even with non-obstructive coronary artery disease (CAD). This biologically regulated process, similar to bone formation, offers a better risk assessment than traditional methods.
Area of Science:
- Cardiovascular Medicine and Imaging
- Biomedical Engineering
Context:
- Coronary artery disease (CAD) stems from atherosclerosis, a vascular disorder impacting endothelial function and leading to vessel occlusion.
- Traditional CAD risk factors have limited ability to predict hard events; emphasis on stenosis severity can be misleading.
- Most acute coronary events occur in patients with non-critical arterial stenoses.
Purpose:
- To review the role of coronary calcification as a surrogate marker for assessing hard event risk in individuals.
- To discuss coronary calcification as a biologically regulated process akin to bone formation.
- To explore noninvasive imaging methods like electron beam computed tomography (EBCT) for identifying unstable coronary plaques.
Summary:
- Coronary calcium is closely linked to atherosclerotic plaque development and serves as a valuable risk assessment marker.
- Coronary calcification is a dynamic, biologically regulated process, not merely passive mineral deposition.
- Advanced imaging techniques can detect vulnerable plaques in asymptomatic individuals, aiding in early risk stratification.
Impact:
- Coronary calcium assessment offers improved risk stratification for hard cardiovascular events compared to traditional methods.
- Understanding the biological regulation of coronary calcification may reveal new therapeutic targets.
- Noninvasive imaging of coronary plaques provides crucial insights for managing acute coronary syndromes.
Abstract:
Coronary acute syndromes (CAD) are the result of atherosclerosis, a vascular disorder characterized by abnormalities in endothelial function, ultimately resulting to partial or complete vessel occlusion. Although recognized risk factors for CAD are helpful to predict the development of atherosclerosis, their ability to identify individual patients at risk of hard events is limited. In addition research has showed that excessive emphasis on the severity of coronary luminal stenosis may be misleading, and the majority of acute events occurs in patients with pre-existing noncritical arterial stenoses. Coronary calcium is intimately associated with coronary atherosclerotic plaque development, and may be used as surrogate marker to assessment the risk for an hard event in an individual subject. Coronary calcification is not a passive process of mineral precipitation but a biologically regulated phenomenon that has many similarities to bone formation. New imaging noninvasive methods, as electron beam computed tomography (EBCT), are able to identify, in asymptomatic patients, unstable coronary plaques that underline the clinical acute coronary syndromes. After a detailed description of the abovementioned context, clinical implications, diagnostic approaches and prospects for therapy of coronary calcifications are reviewed and discussed.
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