Tissue-Nonspecific Alkaline Phosphatase Inhibition Reduces Atherosclerotic Plaque Development

Background and Aims: The calcium score predicts cardiovascular mortality but the impact of calcification on plaque stability remains controversial. Tissue-nonspecific alkaline phosphatase (TNAP), the main enzyme involved in bone mineralization, is expressed in calcified mouse plaques, and is also elevated in the blood of individuals with metabolic syndrome, in whom it is associated with cardiovascular mortality. Therefore, we aimed to determine the involvement of TNAP in plaque calcification and progression.