Author + information
- Received August 10, 2017
- Revision received September 29, 2017
- Accepted October 12, 2017
- Published online January 1, 2018.
- Hiroyoshi Mori, MDa,
- Sho Torii, MDa,
- Matthew Kutyna, MSa,
- Atsushi Sakamoto, MDa,
- Aloke V. Finn, MDa,b,∗ ( and )
- Renu Virmani, MDa
- aCardiovascular Pathology Institute, Gaithersburg, Maryland
- bUniversity of Maryland, School of Medicine, Baltimore, Maryland
- ↵∗Address for correspondence:
Dr. Aloke V. Finn, Cardiovascular Pathology Institute, University of Maryland, 19 Firstfield Road, Gaithersburg, Maryland 20878.
Coronary artery calcification is concomitant with the development of advanced atherosclerosis. Coronary artery calcification pathologically begins as microcalcifications (0.5 to 15.0 μm) and grows into larger calcium fragments, which eventually result in sheet-like deposits (>3 mm). This evolution is observed to occur concurrently with the progression of plaque. These fragments and sheets of calcification can be easily identified by radiography as well as by computed tomography and intravascular imaging. Many imaging modalities have proposed spotty calcification to be a predictor of unstable plaque and have suggested more extensive calcification to be associated with stable plaques and perhaps the use of statin therapy. We will review the pathology of coronary calcification in humans with a focus on risk factors, relationship with plaque progression, correlation with plaque (in)stability, and effect of pharmacologic interventions.
This study was supported by CVPath Institute, Inc., a not-for-profit research organization dedicated to the study of cardiovascular disease. Dr. Mori has received honoraria from Terumo Corporation, Abbott Vascular Japan, and Goodman. Dr. Virmani has received research support from 480 Biomedical, Abbott Vascular, ART, BioSensors International, Biotronik, Boston Scientific, Celonova, Claret Medical, Cook Medical, Cordis, Edwards Lifescience, Medtronic, MicroPort, MicroVention, OrbusNeich, ReCore, SINO Medical Technology, Spectranetics, Surmodics, Terumo Corporation, W.L. Gore and Xeltis; and has received honoraria from 480 Biomedical, Abbott Vascular, Boston Scientific, Cook Medical, Lutonix, Medtronic, Terumo Corporation and W.L. Gore; and consults with 480 Biomedical, Abbott Vascular, Medtronic, and W.L. Gore. Dr. Finn has sponsored research agreements with Boston Scientific and Medtronic; and is an advisory board member to Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 10, 2017.
- Revision received September 29, 2017.
- Accepted October 12, 2017.
- 2018 American College of Cardiology Foundation
- Central Illustration
- Types and Pathology of Calcification in Atherosclerosis
- Natural Progression of Calcification With Plaque Type
- Age, Sex, and Calcification
- Race and Calcification
- Diabetes and Calcification
- Calcification With Plaque Stability
- Progression in Response to Pharmacologic Intervention
- Intravascular Imaging and Calcification
- CT and Calcification
- Clinical Perspective