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Updated: Jun 9, 2026

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Association of colony-forming units with coronary artery and abdominal aortic calcification
Susan Cheng1, Kenneth S Cohen, Stanley Y Shaw
1Cardiology Division, GRB-800, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Insights
Lower numbers of endothelial progenitor cells, crucial for blood vessel repair, are linked to increased atherosclerosis in arteries. This suggests reduced angiogenic potential may drive disease development.
Area of Science:
- Cardiovascular Research
- Cell Biology
- Medical Science
Background:
- Endothelial progenitor cells (EPCs) possess angiogenic activity.
- Depletion of EPCs may promote atherogenesis.
- Limited human data link EPCs to subclinical atherosclerosis.
Purpose of the Study:
- Investigate the association between EPCs and subclinical atherosclerosis in humans.
- Determine if EPC numbers correlate with coronary artery calcification and abdominal aortic calcification.
Main Methods:
- Studied 889 participants from the Framingham Heart Study without clinical cardiovascular disease.
- Assessed EPCs using an early-outgrowth colony-forming unit (CFU) assay and cell surface markers.
- Quantified subclinical atherosclerosis via coronary artery calcification and abdominal aortic calcification using computed tomography.
Main Results:
- Lower EPC colony-forming units correlated with higher coronary artery and abdominal aortic calcification.
- Each 1-SD increase in CFUs was associated with a ~16-17% decrease in calcification, independent of risk factors.
- Specific markers (CD34+/KDR+, CD34+) showed no significant association with calcification.
Conclusions:
- Reduced EPC numbers are associated with increased subclinical atherosclerosis burden in the coronary arteries and aorta.
- Decreased angiogenic potential may contribute to atherosclerosis development in the human population.
Background:
Certain bone marrow-derived cell populations, called endothelial progenitor cells, have been reported to possess angiogenic activity. Experimental data suggest that depletion of these angiogenic cell populations may promote atherogenesis, but limited data are available on their relation to subclinical atherosclerotic cardiovascular disease in humans.
Methods And Results:
We studied 889 participants of the Framingham Heart Study who were free of clinically apparent cardiovascular disease (mean age, 65 years; 55% women). Participants underwent endothelial progenitor cell phenotyping with an early-outgrowth colony-forming unit assay and cell surface markers. Participants also underwent noncontrast multidetector computed tomography to assess the presence of subclinical atherosclerosis, as reflected by the burden of coronary artery calcification and abdominal aortic calcification. Across decreasing tertiles of colony-forming units, there was a progressive increase in median coronary artery calcification and abdominal aortic calcification scores. In multivariable analyses adjusting for traditional cardiovascular risk factors, each 1-SD increase in colony-forming units was associated with a ≈16% decrease in coronary artery calcification (P=0.02) and 17% decrease in abdominal aortic calcification (P=0.03). In contrast, neither CD34(+)/KDR(+) nor CD34(+) variation was associated with significant differences in coronary or aortic calcification.
Conclusions:
In this large, community-based sample of men and women, lower colony-forming unit number was associated with a higher burden of subclinical atherosclerosis in the coronary arteries and aorta. Decreased angiogenic potential could contribute to the development of atherosclerosis in humans.
Related Concept Videos
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Coronary Artery Disease I: Introduction
Coronary Artery Disease II: Pathophysiology
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Atherosclerosis I: Introduction
Acute Coronary Syndrome III: Diagnostic Studies

