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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:e172.)
© 2004 American Heart Association, Inc.

Letters to the Editor

Clinical Significance of Coronary Calcification

Raimund Erbel; Axel Schmermund

Department of Cardiology, University Clinic Essen, Germany

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

We read with interest the review by Abedin et al, who provide valuable insights into the mechanisms of vascular calcification and teleological concepts.¹ However, regarding the clinical ramifications, they make diverse statements. We agree that, in patients selected by knowledgeable physicians, coronary artery calcification can be used "... for identifying patients at risk for adverse cardiac events." This position has been adopted in American and European guidelines.^2,3 However, only 2 paragraphs below, the authors state that "a consensus has developed that coronary calcification is associated with chronic symptomatic coronary artery disease rather than with acute coronary events... " and that "these findings have been interpreted as evidence that vascular calcification is protective against acute events." We believe these statements are misleading. They are based on perceptions from cross-sectional data comparing patients who present with acute coronary syndromes and chronic stable angina pectoris. In many patients, the acute coronary syndrome is the first manifestation of coronary artery disease,⁴ whereas many patients with chronic disease have a long-standing diagnosis. When comparing findings in unstable and stable patients, the different medical history and time course of the disease needs to be taken into account. Intravascular ultrasound studies have produced contradictory results and have in part observed that calcification appeared neutral or even associated with acute coronary events.^5,6

A series of histopathologic reports have been published by the Armed Forces Institute of Pathology group that characterize the relationship between plaque rupture and calcification in some detail.^7–10 These reports demonstrate that calcification . . . [Full Text of this Article]

Moeen Abedin; Yin Tintut; Linda L. Demer

Departments of Medicine, Physiology, and Biomedical Engineering, University of California, Los Angeles

This article has been cited by other articles:

				L. L. Demer, A. P. Sage, and Y. Tintut Nanoscale Architecture in Atherosclerotic Calcification Arterioscler Thromb Vasc Biol, November 1, 2008; 28(11): 1882 - 1884. [Full Text] [PDF]