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Calcification plays an important role in the pathogenesis of atherosclerosis and begins early on in the disease process. The presence of calcium has long been seen as a surrogate marker of atherosclerosis and is a well-established predictor of cardiac risk. Evidence suggests that different calcification patterns are associated with different histopathological and clinical features. At the patient level, the presence of macrocalcification, as assessed by the coronary calcium score, confers worst outcomes. At the plaque level, microcalcification rather than macrocalcification denotes plaque vulnerability. Improved non-invasive imaging modalities may allow for a more comprehensive assessment of atherosclerotic calcification and help identify patients at increased risk of clinical sequelae.

Original publication




Journal article



Publication Date





75 - 84


Atherosclerosis, Disease activity, Inflammation, Macrocalcification, Microclacification, Atherosclerosis, Biomarkers, Calcinosis, Coronary Artery Disease, Humans, Plaque, Atherosclerotic, Positron-Emission Tomography, Vascular Calcification