What Is Coronary Artery Calcification?

Calcification of atherosclerosis, like bone formation, is a complex, organic, regulated, and active process, which is the manifestation of atherosclerosis One of the forms.

Coronary calcification

Calcification of atherosclerosis, like bone formation, is a complex, organic, regulated, and active process, which is the manifestation of atherosclerosis One of the forms.

Chinese name

Coronary calcification

Foreign name

calcification

Category

disease

Belong to

Atherosclerosis

Three hundred years ago, Thebesius first observed the calcium deposition in the coronary arteries. Later, people regarded this calcium deposition as a prominent pathological feature of coronary atherosclerosis. By the mid-twentieth century, most scholars believed that calcium deposition was only a degenerative form of progressive atherosclerotic disease. In recent years, perceptions of atherosclerosis calcifications have changed significantly.

Coronary atherosclerosis and calcification

A large number of studies have shown that the degree of coronary artery stenosis revealed by coronary angiography does not have a linear relationship with the occurrence of subsequent coronary heart disease events, and is more likely to be related to the stability of the coronary artery wall, that is, the stability of coronary atherosclerotic plaques . Unstable plaques have cracks or even ruptures, and acute coronary syndromes occur.

Atherosclerosis calcification can occur in young people in their twenties. Further research found that this younger adult's disease is the accumulation of crystalline calcium in the lipid bodies of the lipid core. Calcium deposition is more common and more severe in older populations. In most progressive lesions, when mineralization is dominant, it is shown to include precipitation of lipid components and increase in fibrous tissue.

Mineralization

Coronary artery calcification (ie, the accumulation of calcified plaques seen on computed tomography)

Clinical studies have shown that the progression of coronary atherosclerosis is a strong independent predictor of future coronary heart disease events. Margolis et al studied 800 patients with angina pectoris and observed that the 5-year survival rate of patients with calcification and symptom on traditional X-ray examination was 58%, while the 5-year survival rate of those without calcification was 87%. Therefore, the prognostic significance of coronary calcification seems to be independent of age, sex, and coronary angiopathy. In addition, coronary calcification was independent of exercise test and left ventricular ejection fraction. Detrano et al.'S study also indicates that traditional X-ray examination of coronary artery calcification can help identify an increased risk of cardiac events in asymptomatic high-risk patients during 1 year. Naito et al. Followed up 241 elderly patients for 4 years and found that 4.9% of the 82 patients with coronary artery calcification had a myocardial infarction, while none of the 159 patients without coronary artery calcification had a myocardial infarction, but the total deaths of these two groups There was no significant difference in rates.

Some review literature points out that calcification of atherosclerosis is clearly associated with disease severity and poor prognosis, so coronary calcification is considered a "bad" phenomenon. However, some clinical and biomechanical studies have shown that calcium deposition tends to reduce the vulnerability of plaque rupture, so that coronary calcification seems to be a "good" sign. Objective evaluation should consider that coronary calcification has two effects at the same time. Calcium deposition indicates the presence of atherosclerotic lesions. In general, the more severe the calcium deposits, the wider the range of atherosclerotic lesions. A group of atherosclerotic lesions, especially unstable lesions, are prone to cause coronary heart disease events. However, unstable lesions may be non-calcifying, while stable lesions are more likely to be calcifying.

Coronary artery calcification is considered a "bad" phenomenon because the number of calcified plaques roughly reflects the total area of atherosclerosis in the coronary branches. However, the factors that determine the prognosis of coronary arteries are not only related to the amount of atherosclerosis, but also related to the possibility that each plaque is prone to rupture. In a sense, calcification may mean a protective effect.