Coronary artery calcification: pathogenesis and prognostic implications

J Am Coll Cardiol. 2014 May 6;63(17):1703-14. doi: 10.1016/j.jacc.2014.01.017. Epub 2014 Feb 12.


Coronary artery calcification (CAC) is a risk factor for adverse outcomes in the general population and in patients with coronary artery disease. The pathogenesis of CAC and bone formation share common pathways, and risk factors have been identified that contribute to the initiation and progression of CAC. Efforts to control CAC with medical therapy have not been successful. Event-free survival is also reduced in patients with coronary calcification after both percutaneous coronary intervention (PCI) and bypass graft surgery. Although drug-eluting stents and devices for plaque modification have modestly improved outcomes in calcified vessels, adverse event rates are still high. Innovative pharmacologic and device-based approaches are needed to improve the poor prognosis of patients with CAC.

Keywords: PCI; coronary artery calcification; coronary artery disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Calcinosis* / diagnostic imaging
  • Calcinosis* / epidemiology
  • Calcinosis* / surgery
  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / epidemiology
  • Coronary Artery Disease* / surgery
  • Diagnosis, Differential
  • Drug-Eluting Stents*
  • Global Health
  • Humans
  • Incidence
  • Percutaneous Coronary Intervention / methods*
  • Prognosis
  • Tomography, X-Ray Computed