Karlöf E, et al. - Researchers investigated whether calcification is a stabilizing feature of plaques and focused on the correlation between macro-calcification (as estimated by computed tomography) and gene expression profiles in carotid lesions. In chronic kidney disease patients, the plaques and arteries with medial calcification were assessed using immunohistochemistry and qPCR. Findings revealed a correlation between macro-calcification in carotid lesions and a transcriptional profile characteristic for stable plaques, with changed smooth muscle cell phenotype and extracellular matrix (ECM) composition and repressed inflammation. Enrichment of proteoglycan 4 (previously not described in atherosclerosis) in the calcified ECM, as well as localization to activated macrophages and smooth muscle-like cells, was reported in this study. Overall, the assumption that calcification evaluation may help in the assessment of plaque phenotype and stroke risk was reinforced based on the findings.