Research Progress on Mechanisms and Pharmacological Interventions of Coronary Artery Calcification

Coronary artery calcification (CAC) is a critical determinant of cardiovascular morbidity and mortality. Current research identifies CAC as an active biological process driven by vascular smooth muscle cell (VSMC) osteogenic transdifferentiation, chronic inflammation, oxidative stress, and metabolic dysregulation. These pathological changes are orchestrated by complex signaling networks that promote mineral deposition in the arterial wall. Emerging pharmacological interventions, including denosumab, vitamin K2, and SNF472, have demonstrated potential in attenuating CAC progression by targeting these specific pathways. Conversely, widely prescribed medications such as statins exhibit complex, dual effects on calcification, necessitating careful clinical evaluation. This review synthesizes the core molecular mechanisms underlying CAC and critically evaluates current and emerging pharmacological strategies, providing mechanistic insights to guide future precision management.