Evidence map›Paper›PMID 42278635›Full record

ReviewInternational journal of molecular sciences2026

Coronary Artery Calcification: From Molecular Mechanisms to Interventional Strategies.

Stefan Zivkovic, Vojko Misevic, Kosta Krupnikovic, Aleksa Obradovic, Stefan Timcic, Aleksandar Mandic, Stefan Juricic, Jelena Rakocevic, Milovan Bojic, Milan Dobric

Abstract readReview
In one paragraph

Review in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Stefan ZivkovicInstitute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.
Vojko MisevicInstitute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.
Kosta KrupnikovicInstitute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.ORCID 0009-0002-7886-6763
Aleksa ObradovicInstitute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.ORCID 0009-0006-2509-9782
Stefan TimcicInstitute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.
Aleksandar MandicInstitute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.
Stefan JuricicCardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia.ORCID 0000-0002-3045-5263
Jelena RakocevicInstitute of Histology and Embryology "Aleksandar Dj. Kostic", Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.ORCID 0000-0001-8365-4840
Milovan BojicInstitute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.
Milan DobricInstitute for Cardiovascular Diseases "Dedinje", 11000 Belgrade, Serbia.ORCID 0000-0001-7643-0451

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Coronary artery calcification (CAC) represents a clear sign of advanced atherosclerosis and a strong indicator of coronary artery disease burden and cardiovascular risk. Beyond its established prognostic value, CAC significantly influences plaque biology, lesion morphology, and the technical complexity of percutaneous coronary intervention (PCI). This review summarizes current knowledge on the mechanisms of vascular calcification, its clinical determinants, diagnostic assessment, and therapeutic implications. Vascular calcification is now understood as an active, regulated process involving osteogenic transdifferentiation of vascular smooth muscle cells, inflammatory signaling pathways, extracellular vesicle release, and disturbances in mineral metabolism. Distinct calcification phenotypes exert different effects on plaque stability: micro- and spotty calcifications are frequently linked to plaque vulnerability, whereas dense, sheet-like calcification is more typical of stable fibrocalcific lesions. The prevalence of CAC increases with age and differs between sexes, while cardiometabolic risk factors, chronic kidney disease, systemic inflammation, and genetic predisposition further contribute to its development. Noninvasive computed tomography remains the cornerstone for CAC detection and quantification, enabling reliable cardiovascular risk stratification. Intravascular imaging techniques, particularly intravascular ultrasound and optical coherence tomography, provide detailed characterization of calcified plaque morphology and support optimal procedural planning. In patients with heavily calcified lesions, intravascular imaging-guided lesion preparation and stent optimization represent the most effective strategy for improving PCI outcomes.

Indexed as

Coronary Artery DiseaseVascular CalcificationHumansPercutaneous Coronary InterventionTreatment Outcomecalcium-modifying strategiescoronary artery calcificationintravascular imagingplaque morphology

Identifiers

PMID42278635
PMCPMC13257857

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.