Drs. Zincarelli and Iervolino contributed equally to this work.
Diffuse idiopathic skeletal hyperostosis prevalence in subjects with severe atherosclerotic cardiovascular diseases
Article first published online: 27 OCT 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 11, pages 1765–1769, November 2012
How to Cite
Zincarelli, C., Iervolino, S., Di Minno, M. N. D., Miniero, E., Rengo, C., Di Gioia, L., Vitale, D., Nicolino, A., Furgi, G. and Pappone, N. (2012), Diffuse idiopathic skeletal hyperostosis prevalence in subjects with severe atherosclerotic cardiovascular diseases. Arthritis Care Res, 64: 1765–1769. doi: 10.1002/acr.21742
- Issue published online: 27 OCT 2012
- Article first published online: 27 OCT 2012
- Accepted manuscript online: 23 MAY 2012 03:10PM EST
- Manuscript Accepted: 9 MAY 2012
- Manuscript Received: 4 MAR 2012
Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by ossification of different entheseal sites. Several metabolic factors have been suggested to be involved in DISH development. We assessed the prevalence of DISH and its relationship to traditional vascular risk factors in a cohort of patients diagnosed with cardiovascular diseases.
Among the 521 consecutive patients admitted to the heart diseases rehabilitation program in our Rehabilitative Cardiology Unit, only those (n = 436) with recent coronary artery bypass grafting (CABG), a heart valve replacement (HVR), or congestive heart failure (CHF) were enrolled (45 CHF, 338 CABG, and 53 HVR). All patients underwent a rheumatologic examination, blood sample collections, and chest radiographs. Body mass index (BMI), blood pressure, and information about sex, age, smoking habit, and other vascular risk factors were recorded. DISH was established according to the Resnick and Niwayama criteria.
In the setting (77.1% men), the mean ± SD age was 65.44 ± 9.66 years and the overall prevalence of DISH was 30.3%. A logistic regression analysis showed that both age (odds ratio [OR] 1.076, 95% confidence interval [95% CI] 1.044–1.109; P < 0.001) and obesity (OR 2.28, 95% CI 1.33–3.89; P = 0.003) were significant predictors of the presence of DISH. An increasing OR for the presence of DISH was found for increasing tertiles of age and BMI. No difference resulted according to other traditional vascular risk factors. BMI and age directly correlated with C-reactive protein levels.
The overall prevalence of DISH was 30.3%. This is expected because of the study population. Obese and older individuals exhibit a higher risk of DISH development.