Giving Calcification Its Due: Recognition of a Diverse Disease

C ardiovascular calcification is a growing burden and a leading predictor of and contributor to acute cardiovascular events. Arterial calcification associates with a 4-fold increase in cardiovascular events, and patients with aortic valve calcification have a 5-year event-free survival rate of only 26%, 1,2 worse than that of many cancers. Despite massive healthcare costs and extensive research efforts, effective therapeutic strategies remain elusive. Cardiovascular calcification, often generalized as one disease, is in reality a multifaceted disorder that occurs in diverse milieus as a result of multiple, interacting pathogenic processes. Herein, we explore these variables and propose a set of guidelines for studying cardiovascular calcification.