Röder, Franziska (2022) THE MODIFIED AGATSTON CALCIUM SCORE MAY PREDICT OUTCOME OF ENDARTERECTOMY IN PATIENTS WITH CAROTID STENOSIS. thesis, Medicine.
Full text available on request.Abstract
Background: Cardiovascular disease accounts for the primary cause of morbidity and mortality worldwide. In cardiology, the well-established Agatston calcium score acts as an independent predictor of cardiovascular events and all-cause mortality. This study aimed to determine the relationship between preoperative calcium scores (CaScores) in the carotid artery and postoperative all-cause mortality in patients undergoing carotid endarterectomy (CEA). The same principles as seen with the Agatston calcium score are sought to be applied in this patient population. Secondary outcomes were the relationship between CaScores and occlusion time, and shunt use during surgery. The aim is to improve patient care by selecting surgical candidates with a low-risk profile regarding postoperative adverse events. Methods: This retrospective cohort consisted of 71 patients who underwent a CEA at the University Medical Center of Groningen (UMCG) between 2010 and 2018. Preoperative CaScores were measured on contrast-enhanced computed tomography (CT) images with a fixed threshold of 420 Hounsfield units (HU). The relationship between these CaScores and all-cause mortality was analyzed using Kaplan-Meier survival analysis and multivariate cox regression analysis. Results: Significant differences in cumulative survival between the low-medium Ca-group and the high Ca-group were seen in the Kaplan-Meier survival curve (Log-rank test, p < 0.0001). The median survival was 103 (96,134) and 60 (34,97) months for the low-medium and high Ca-group respectively. In the multivariable Cox regression, after adjusting for confounding cardiovascular risk factors, the high Ca-group had a significant association with all-cause mortality (hazard ratio 5.46, 95%CI 2.02-14.79, p < 0.0001). Conclusion: This study identified a significant independent relationship between preoperative CaScores and postoperative survival in our study population. These promising results may enable better identification of patients at risk for (cardiovascular) death and thus better selection of surgical candidates. More extensive research is needed in this field to confirm the applicability of CaScores in atherosclerotic carotid disease.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Pol, MD,PhD, Robert A. and Zeebregts, MD, PhD2, Professor Clark J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Jun 2023 13:04 |
| Last Modified: | 23 Jun 2023 13:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3560 |
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