Medial Arterial Calcification: JACC State-of-the-Art Review

Overview

Journal J Am Coll Cardiol

Specialty Cardiology & Vascular Diseases

Date 2021 Sep 10

PMID 34503684

Citations 99

Authors

Peter Lanzer

Fadil M Hannan

Jan D Lanzer

Jan Janzen

Paolo Raggi

Dominic Furniss

Mirjam Schuchardt

Rajesh Thakker

Pak-Wing Fok

Julio Saez-Rodriguez

Angel Millan

Yu Sato

Roberto Ferraresi

Renu Virmani

Cynthia St Hilaire

Affiliations

Soon will be listed here.

Abstract

Medial arterial calcification (MAC) is a chronic systemic vascular disorder distinct from atherosclerosis that is frequently but not always associated with diabetes mellitus, chronic kidney disease, and aging. MAC is also a part of more complex phenotypes in numerous less common diseases. The hallmarks of MAC include disseminated and progressive precipitation of calcium phosphate within the medial layer, a prolonged and clinically silent course, and compromise of hemodynamics associated with chronic limb-threatening ischemia. MAC increases the risk of complications during vascular interventions and mitigates their outcomes. With the exception of rare monogenetic defects affecting adenosine triphosphate metabolism, MAC pathogenesis remains unknown, and causal therapy is not available. Implementation of genetics and omics-based approaches in research recognizing the critical importance of calcium phosphate thermodynamics holds promise to unravel MAC molecular pathogenesis and to provide guidance for therapy. The current state of knowledge concerning MAC is reviewed, and future perspectives are outlined.

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