{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:34:46Z","timestamp":1788863686267,"version":"build-2803163510"},"reference-count":152,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"American Heart Association Postdoctoral Fellowship","award":["18POST33990046"],"award-info":[{"award-number":["18POST33990046"]}]},{"name":"American Heart Association Postdoctoral Fellowship","award":["S0199\/10097\/2023"],"award-info":[{"award-number":["S0199\/10097\/2023"]}]},{"name":"University of Eastern Finland (Researcher Fellowship)","award":["18POST33990046"],"award-info":[{"award-number":["18POST33990046"]}]},{"name":"University of Eastern Finland (Researcher Fellowship)","award":["S0199\/10097\/2023"],"award-info":[{"award-number":["S0199\/10097\/2023"]}]},{"name":"Finnish Foundation for Cardiovascular Research","award":["18POST33990046"],"award-info":[{"award-number":["18POST33990046"]}]},{"name":"Finnish Foundation for Cardiovascular Research","award":["S0199\/10097\/2023"],"award-info":[{"award-number":["S0199\/10097\/2023"]}]},{"name":"German Centre for Cardiovascular Research (DZHK)","award":["18POST33990046"],"award-info":[{"award-number":["18POST33990046"]}]},{"name":"German Centre for Cardiovascular Research (DZHK)","award":["S0199\/10097\/2023"],"award-info":[{"award-number":["S0199\/10097\/2023"]}]},{"name":"Junior Investigator Award from Foundation Leducq","award":["18POST33990046"],"award-info":[{"award-number":["18POST33990046"]}]},{"name":"Junior Investigator Award from Foundation Leducq","award":["S0199\/10097\/2023"],"award-info":[{"award-number":["S0199\/10097\/2023"]}]},{"name":"Junior Research Cardiovascular Diseases Grant of the CORONA Foundation","award":["18POST33990046"],"award-info":[{"award-number":["18POST33990046"]}]},{"name":"Junior Research Cardiovascular Diseases Grant of the CORONA Foundation","award":["S0199\/10097\/2023"],"award-info":[{"award-number":["S0199\/10097\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Coronary artery calcification (CAC) is mainly associated with coronary atherosclerosis, which is an indicator of coronary artery disease (CAD). CAC refers to the accumulation of calcium phosphate deposits, classified as micro- or macrocalcifications, that lead to the hardening and narrowing of the coronary arteries. CAC is a strong predictor of future cardiovascular events, such as myocardial infarction and sudden death. Our narrative review focuses on the pathophysiology of CAC, exploring its link to plaque vulnerability, genetic factors, and how race and sex can affect the condition. We also examined the connection between the gut microbiome and CAC, and the impact of genetic variants on the cellular processes involved in vascular calcification and atherogenesis. We aimed to thoroughly analyze the existing literature to improve our understanding of CAC and its potential clinical and therapeutic implications.<\/jats:p>","DOI":"10.3390\/cells12242822","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T05:23:22Z","timestamp":1702358602000},"page":"2822","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Beyond the Basics: Unraveling the Complexity of Coronary Artery Calcification"],"prefix":"10.3390","volume":"12","author":[{"given":"Satwat","family":"Hashmi","sequence":"first","affiliation":[{"name":"Department of Biological and Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pashmina Wiqar","family":"Shah","sequence":"additional","affiliation":[{"name":"Institute for Cardiogenetics, Universit\u00e4t zu L\u00fcbeck, 23562 L\u00fcbeck, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck, University Heart Centre L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zouhair","family":"Aherrahrou","sequence":"additional","affiliation":[{"name":"Institute for Cardiogenetics, Universit\u00e4t zu L\u00fcbeck, 23562 L\u00fcbeck, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck, University Heart Centre L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Aikawa","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8148-9554","authenticated-orcid":false,"given":"R\u00e9douane","family":"Aherrahrou","sequence":"additional","affiliation":[{"name":"Institute for Cardiogenetics, Universit\u00e4t zu L\u00fcbeck, 23562 L\u00fcbeck, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck, University Heart Centre L\u00fcbeck, 23562 L\u00fcbeck, Germany"},{"name":"A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, FI-70211 Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1161\/ATVBAHA.113.302642","article-title":"Has Our Understanding of Calcification in Human Coronary Atherosclerosis Progressed?","volume":"34","author":"Otsuka","year":"2014","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.jcmg.2017.05.007","article-title":"Coronary artery calcium scoring: Is it time for a change in methodology?","volume":"10","author":"Blaha","year":"2017","journal-title":"JACC Cardiovasc. 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