*Geek Box: Coronary Artery Calcification
Calcification of tissues is a process that can occur in response to injury. In the process of atherosclerosis development – which occurs over decades, often from the second decade of life – the arteries are exposed to repeated injury from trapped cholesterol, and the resulting immune responses and inflammatory responses that occur. The lesions that occur in the artery as a result become calcified. The extent of coronary artery calcification is strongly correlated with the extent of atherosclerosis, and is highly predictive of cardiovascular disease mortality.
Coronary artery calcification [CAC] results in impaired vascular function, and blood flow to the heart. However, unless identified by an angiography, CAC is asymptomatic, and does not have any specific clinical manifestation [unlike, for example, high blood cholesterol levels]. The two primary risk factors for CAC are age and biological sex, with evidence of CAC in >90% of men over the age of 70yrs, and in >67% of women over the same age.
CAC is defined by the “Agatston score”: 0 = no calcification; 100-300 = moderate calcification; >300 = severe calcification. To date, there is no established intervention to treat CAC, either pharmacologically, surgically, or nutritionally. In addition, the exact pathophysiology of CAC remains to be fully elucidated. Nonetheless, CAC is very important for prognosis of cardiovascular disease risk in both primary and secondary prevention.