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. Author manuscript; available in PMC: 2022 Sep 14.
Published in final edited form as: J Am Coll Cardiol. 2021 Sep 14;78(11):1145–1165. doi: 10.1016/j.jacc.2021.06.049

Central Illustration. MAC: A Systemic Vascular Disorder Devastating Peripheral Circulation.

Central Illustration.

. In health calcium phosphate (CaP) homeostasis is maintained and crystallization prevented. In MAC CaP homeostasis brakes down resulting in progressive mineralization and in more advanced stages, bone formation within the medial layer. A number of pathogenetic principles including smooth muscle cells osteogenic differentiation, apoptosis, inflammation, molecular defects of matrisome have been reported to regulate the calcification process (left panels). MAC impairs hemodynamics often causing chronic limb threatening ischemia (right panels). Omics approaches holds distinct promise to define MAC molecular pathogenesis and design treatments (central panels).