Objective: T he aim of this study was to evaluate the correlation between iliac calcium score (ICS) and the iliac intima-media thickness (i-IMT), as possible new imaging-derived biomarkers related with both PAD complexity and severity of systemic atherosclerosis.
Methods: The study included 90 consecutive subjects admitted with symptomatic peripheral arterial disease, undergoing peripheral CTA examination of the lower extremities. The CTA complexity of the vascular lesions was evaluated on the basis of TASC classification. Results: CT-based TASC evaluation assigned 26 subjects to TASC B, 39 subjects to TASC C and 25 sub-jects to TASC D class. ICS results presented a gradual increase with TASC class (3413 +/- 3232, 95%CI 1784 – 4715 for TASC B, 5721 +/- 4643, 95%CI 4638 – 6351 for TASC C, and 6265 +/- 3814, 95%CI 4521 – 8319 for TASC 4). At the group assessment, ICS values were sig-nificantly higher in TASC D vs TASC B class (p=0.02) and in TASC C vs. TASC B class (p=0.02). ICS and i-IMT linear regression analysis revealed a very good positive association (r=0.55, p<0.0001 for right iliac artery, r=0.62, p<0.0001 for left iliac artery and r=0.61, p<0.0001 for both iliac arteries averaged). Subjects with increased ICS presented a significantly lower left ventri-cular ejection fraction (LVEF) as compared with those with low ICS (43.2 +/- 3.7 vs. 53.6 +/- 4.2, p<0.0001). Moreover, linear regression analysis demonstrated a significant inverse correlation between ICS values and left ventricular EF (r=-0.54, p<0.0001).
Conclusions: Increased values of ICS are correlated with a higher severity and complexity of both PAD and systemic atherosclerosis. Left ventricular performance deterioration could be predicted by ICS elevated valu-es, as an effect of systemic atherosclerotic disease.