Wahab, Norhazura Abdul
(2018)
Predictive factors of arterial calcification severity in computed tomography angiography (CTA) lower limbs.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: The use of multi-detector row technology has resulted in shorter
acquisition time, increased volume coverage, lower dose of contrast medium, and
improved spatial resolution for assessing small arterial branches. However the
accuracy of the computed tomography angiography (CTA) examination may be
degraded by the presence of calcified plaque. The objective of this study is to evaluate
the factors that contribute to the severity of arterial calcification in CT lower limbs.
Methodology: A cross sectional study that conducted in Hospital Universiti Sains
Malaysia. CT lower limbs with calcifications from January 2010 to May 2017 were
selected for this study. Patients who were amputated, CT images with metallic stent,
and those with inadequate clinical information were excluded from the study. The
calcium score was analyzed using the standardized calcium score software that was
used for coronary arteries. Calcium score was divided into low and high using normal
distribution curve. Possible clinical factors that affect arterial calcification were
studied such as peripheral arterial disease symptoms, history of acute coronary
symptoms, cardiovascular disease, end stage renal disease, blood cholesterol level,
smoker/non-smoker, treated for diabetes/hypertension and latest systolic blood
pressure. Framingham Risk Score was calculated using General cardiovascular
disease Risk Prediction calculator, from official website Framingham Heart Study.
Results: A total of 51 patients was included in the study (n=51) with the mean age
was 67. Majority of the participants were Malay (88.2%). The numbers of male and
female participants were almost equal. Multivariate analysis showed that interrelated
factors that affect log arterial calcium score included age, diabetes, peripheral arterial
disease and low density lipoprotein (R2 =0.589, p<0.001 to 0.015). There weresignificant moderate correlation between Framingham Score and Agatston Score.
(r=0.555, p=0.001).
Conclusion: Age, diabetes mellitus, peripheral arterial disease and low density
lipoprotein are the potential associated factors that can be used to screen for
possibility of severe lower limb arterial calcifications. High Agatston score is
associated with high Framingham risk score.
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