Journal
JACC-CARDIOVASCULAR IMAGING
Volume 11, Issue 1, Pages 127-142Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcmg.2017.10.012
Keywords
calcification; imaging; pathology; stable plaque; unstable plaque
Funding
- CVPath Institute, Inc.
- 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
- Xeltis
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Coronary artery calcification is concomitant with the development of advanced atherosclerosis. Coronary artery calcification pathologically begins as microcalcifications (0.5 to 15.0 mu m) 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. (c) 2018 by the American College of Cardiology Foundation.
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