RT info:eu-repo/semantics/doctoralThesis
T1 Calcium score en arteria iliaca como marcador innovador de carga aterosclerótica total en enfermedad arterial periférica
A1 Martín Morquecho, Irene Teresa
A2 Universidad de Valladolid. Escuela de Doctorado
K1 Enfermedad cardiovascular
K1 Iliac calcium score
K1 Calcio iliaco
K1 Coronary calcium score
K1 Calcio coronario
K1 Cardiovascular imaging
K1 Imagen cardiovascular
K1 Cardiovascular risk
K1 Riesgo cardiovascular
K1 32 Ciencias Médicas
AB Introduction: Cardiovascular diseases are the leading cause of death in our countries. The clinical spectrum of cardiovascular diseases includes peripheral arterial disease (PAD), coronary artery disease (CAD) and cerebrovascular disease (CVD). The etiological substrate of all these diseases is atherosclerosis. Atherosclerosis is characterised  by atheroma plaques in medium and large caliber arteries, a process in which inflammation and calcification are involved. The most common form of atherosclerosis is PAD, followed by CAD. CAD is the main cause of death in these patients.Over the past few decades, significant advances have been made in medical imaging. Among these innovations, the use of calcium scoring has emerged as a valuable tool for assessing the risk of coronary artery disease (CAD). This method not only facilitated the quantification of the extent of calcification, but also allowed for the detection of atherosclerotic plaque burden, providing a cardiovascular risk assessment tool with established diagnostic and prognostic value. The importance of calcium scoring extends beyond the coronary arteries. With the advent of comprehensive imaging techniques, the assessment of calcification has been extended to peripheral arteries as well, including the iliac arteries. However, the potential relationship between calcium scores in these different vascular territories remains underexplored.On the other hand, we now know that the most important risk factor for the development of atherosclerosis is an individual's genetic predisposition. A large number of genetic polymorphisms associated with atherosclerosis and vascular calcification in different territories have been studied.This study aimed to investigate the correlation between coronary artery calcium scores and iliac artery calcium scores, both measured by the Agatston index. The potential implications of this correlation for cardiovascular risk assessment should be explored.The secondary objectives of this study are to investigate the possible relationship between ICS and iliac intima-media thickness (i-IMT) as measured by CT, and genetic markers associated with calcification of the iliac arteries. Research content: An observational cross-sectional, single-centre research design was used. Data were collected from electronic medical records, imaging reports, and clinical databases of patients undergoing coronary and aortic/lower extremity computed tomography angiography. Statistical analyses included Pearson's correlation coefficient, multiple linear regression models, and subgroup analyses. In addition, a case-control study was used to analyse the association between some genetic polymorphisms associated with lipids and iliac artery calcification.  The study included 49 patients (mean age: 66 years, 85 % male), with peripheral arterial disease. Significant positive correlations were found between coronary and iliac artery calcium scores. Regression analysis showed that iliac artery calcium scores were associated with Agatston score, intima-media thickness, diabetes mellitus, chronic kidney disease, arterial hypertension and smoking habit. Subgroup analyses in patients with diabetes mellitus showed similar trends. In addition, a genetic polymorphism associated with lipids (rs10902661) was found to be statistically significantly associated with iliac artery calcification. Conclusions: The study showed a significant positive correlation between coronary and iliac artery calcium scores, suggesting shared common mechanisms of vascular calcification. This correlation may revolutionise risk assessment by providing an additional predictive tool. Iliac artery calcium score were also associated with Agatston score, intima-media thickness, diabetes mellitus, chronic kidney disease, arterial hypertension, and smoking habit. Similar trends were observed in subgroup analyses of patients with diabetes mellitus.The study highlights the potential impact of iliac artery calcification on preventive cardiology. However longitudinal studies are needed to further validate and understand the clinical implications. A significant positive association was observed between a genetic polymorphism associated with lipids (rs10902661) and iliac artery calcification. This support the value of this tool, highlights the important of genetic markers and may have clinical application in the near future.
YR 2025
FD 2025
LK https://uvadoc.uva.es/handle/10324/76239
UL https://uvadoc.uva.es/handle/10324/76239
LA spa
NO Escuela de Doctorado
DS UVaDOC
RD 07-jul-2025