ABSTRACT
The association between vascular calcification and vascular
atherosclerosis has been known to anatomists and patholo-
gists for centuries. The value of coronary artery calcification
(CAC) for predicting the presence of coronary artery disease
and the occurrence of future cardiac events is discussed in
detail elsewhere in this book in chapters 9 (Knez A) and 10
(Shaw LJ et al.). In short, calcium is deposited in diseased
coronary arteries in the form of hydroxyapatite, which con-
tains 40% calcium by weight. The area of CAC is propor-
tional to, but represents only approximately 20 percent of,
the coronary artery plaque area on histological examination
of excised coronary arteries.1 CAC does not correlate well
with the degree of coronary artery narrowing on a site-by-
site basis,2 and the relationship of CAC with coronary artery
plaque that is prone to rupture is not well understood.3
Nonetheless, if used in the appropriate clinical context,
