title: Coronary artery calcification and cardiovascular risk: the role of RANKL/OPG signalling.
abstract: BACKGROUND
  Coronary artery disease (CAD) represents the most relevant cause of death and morbidity in the adult population of developed and developing countries. During the last decades, a strong research effort has been performed to identify more selective markers and better assess the cardiovascular risk in both primary and secondary prevention.
  
  
  METHODS
  This review updates current knowledge regarding the pathophysiological relevance as possible markers of coronary calcification of the receptor activator of nuclear factor-kappa ligand (RANKL)/osteoprotegerin (OPG) system. Furthermore, the potential clinical use of both RANKL/OPG and coronary calcium score (CAC) to assess cardiovascular vulnerability has been discussed.
  
  
  RESULTS
  Emerging evidence indicates that atherosclerotic plaque calcification is positively correlated with vulnerability. Several inflammatory mediators have been shown to modulate arterial calcification, thus increasing the risk of plaque rupture. Among these factors, RANKL/OPG axis might be of particular interest as a promising biomarker of plaque vulnerability in subjects with diffuse coronary calcification.
  
  
  CONCLUSIONS
  Together with clinical parameters of coronary calcification (such as CAC), circulating RANKL/OPG levels could contribute to better assess and predict cardiac events.
authors.affiliation: Division of Cardiology, Department of Medicine, Geneva University Hospital, Foundation for Medical Researches, Geneva, Switzerland.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Quercioli
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montecucco
authors.forename: Maria
authors.initials: M
authors.lastname: Bertolotto
authors.forename: Luciano
authors.initials: L
authors.lastname: Ottonello
authors.forename: Aldo
authors.initials: A
authors.lastname: Pende
authors.forename: François
authors.initials: F
authors.lastname: Mach
authors.forename: Franco
authors.initials: F
authors.lastname: Dallegri
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000378:metabolism*; D002114:Calcinosis / Q000097:blood* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications*; D006801:Humans; D053244:Osteoprotegerin / Q000097:blood* / Q000378:metabolism; D053245:RANK Ligand / Q000097:blood*; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000097:blood*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B