Calcification of the coronary arteries, aorta, heart valves and ischemic heart disease: pathophysiology, relationship, prognosis, risk stratification. Part 1. Pathogenesis and markers of calcium deposition in the vascular wall
Evaluation of subclinical coronary atherosclerosis significantly improves the accuracy of the global cardiovascular risk prediction. Vascular calcification is an independent predictor of ischemic heart disease and is highly correlated with cardiovascular disease mortality. In recent years, several mechanisms to explain vascular calcification have been identified including loss of inhibition, induction of bone formation, circulating nucleation complexes, and cell death. A variety of bone proteins were found in atherosclerotic lesions (osteopontin, osteonectin, fibronectin, osteoprotegerin et al.). The possibility that atherosclerotic calcification occurs by the same molecular mechanism as embryonic bone formation by expression of the potent embryonic bone differentiation factor in human calcified plaque is widely demonstrated in the current literature.