Subjects with diffuse idiopathic skeletal hyperostosis have an increased burden of coronary artery disease: An evaluation in the COPDGene cohort

Oudkerk, Sytse F.; Hoesein, Firdaus A. A. Mohamed; Mali, Willem P.Th.M.; Öner, F. Cumhur; Verlaan, Jorrit Jan; Jong, Pim A. de; Kinney, Gregory L.; Hokanson, John E.; Lynch, David A.; Silverman, Edwin K.; Budoff, Matthew J.; Regan, Elizabeth A.

doi:10.1016/j.atherosclerosis.2019.05.030

Cited by 19 publications

(19 citation statements)

References 29 publications

(33 reference statements)

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“…Although the exact pathophysiology of DISH remains undetermined to date, metabolic factors with low-grade inflammation are thought to contribute to ossification in the disease as DISH has been frequently associated with hyperinsulinemia, type 2 diabetes, obesity, and hypertension ( Mader et al, 2013 ; Mader et al, 2021 ; Harlianto et al, 2021 ). Furthermore, intracerebral and coronary calcifications have also been reported to be increased in patients with DISH ( Mader et al, 2013 ; Oudkerk et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Pseudohypoparathyroidism mimicking cervical diffuse idiopathic skeletal hyperostosis with dysphagia: A case report and literature review

et al. 2021

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Dysphagia due to extensive ossification at anterior segments of the cervical spine is a rare occurrence and is usually attributable to diffuse idiopathic skeletal hyperostosis (DISH). We present the case of a 74-year-old female with dysphagia most likely due to ossification in pseudohypoparathyroidism type 1a (PHP1a). PHP1a is a rare, autosomal dominant disorder caused by mutations in the GNAS1 gene. Our patient had characteristic phenotype features of PHP1a, also known as Albright's hereditary osteodystrophy (AHO), which was diagnosed without genetic confirmation. She was conservatively treated with dietary measures and observation, and reported persisting symptoms of dysphagia at six-month follow-up. This is the first case to describe dysphagia in PHP1a with a similar presentation to DISH.

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Section: Discussionmentioning

confidence: 99%

Pseudohypoparathyroidism mimicking cervical diffuse idiopathic skeletal hyperostosis with dysphagia: A case report and literature review

et al. 2021

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“…Coronary artery calcifications are considered to be a strong risk factor for adverse cardiovascular outcomes. It has recently been shown that patients with DISH have a significantly higher risk of having coronary artery calcifications, even after correction for age, gender, and atherosclerotic risk factors [29]. Thus, DISH itself may contribute to the CVD risk burden.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular disease in diffuse idiopathic skeletal hyperostosis (DISH): from theory to reality—a 10-year follow-up study

et al. 2020

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Objective: To describe actual cardiovascular events over a decade in patients with diffuse idiopathic skeletal hyperostosis (DISH), without previously known CV diseases. Methods: The medical records of patients with DISH and controls, beginning in 2006 (without known CV disease), were reviewed. Demographic, constitutional, and laboratory data were collected. Comparison of CV events following 2006 was performed according to the outcome definitions set by the Framingham score 2: coronary event demonstrated by a coronary imaging modality, acute myocardial infarction (MI), coronary death, congestive heart failure with a reduced ejection fraction, and angina pectoris. Results: Data were available for 45 patients with DISH and 47 controls without DISH from the original cohort (91.8% and 97.9% respectively). By the Framingham score, 28.6% (± 20.33) of the DISH patients were expected to be affected with CVD at 10 years of follow-up. We observed that nearly 39% of them developed CVD during that period (95% CI 23.8-53.5%). The incidence of MI over the 10-year period was significantly higher in the DISH group (P = 0.005). The DISH group had higher morbidity with a higher composite outcome of 38.8% vs 25.5% in the control cohort, and the number of non-elective hospital admissions per patient, despite neither reaching statistical significance. Conclusion: Our study showed that the Framingham score underestimates the real risk for developing CVD in patients with DISH, specifically the risk for MI. We propose more scrutiny is warranted in evaluating CV risk in these patients, more demanding treatment target goals should be established, and earlier and more aggressive medical interventions should be undertaken, particularly primary prevention. Larger prospective studies are needed to corroborate these findings.

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“…diabetes mellitus, obesity, hypertension) has been documented previously (7)(8)(9). Increasing evidence is emerging about the presence of a common pathogenic substrate for metabolic syndrome-associated disorders (including atherosclerosis) and the process of new bone formation in patients with DISH (6,10,19). In fact, approximately half of the patients in the current study had a history of ischaemic cardiovascular events, with a high prevalence of hypertension (57.4%) and diabetes mellitus (34.8%) and a mean BMI of 27.9 kg/m 2 .…”

Section: Discussionmentioning

confidence: 99%

Diffuse idiopathic skeletal hyperostosis in subjects with congestive heart failure undergoing cardiac rehabilitation: A decision tree analysis

Ambrosino¹,

Scrutinio²,

Campi³

et al. 2020

J Rehabil Med

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Diffuse idiopathic skeletal hyperostosis (also known as Forestier's disease) is a systemic condition with a wide spectrum of clinical manifestations. Patients with diffuse idiopathic skeletal hyperostosis often experience pain, stiffness, loss of range of motion, and even difficulty breathing or swallowing. As a consequence, the presence of such disabling symptoms may interfere with activities of daily living and significantly reduce perceived quality of life. Moreover, the ankylosed spine in patients with diffuse idiopathic skeletal hyperostosis is prone to unstable fractures, thus exposing patients to a considerable risk of secondary spinal cord injury. This study found an exceptionally high prevalence of diffuse idiopathic skeletal hyperostosis among patients with congestive heart failure who were undergoing cardiac rehabilitation, particularly in obese and older individuals. Given the risk of spinal fractures, even after low impact trauma, and of severe disability, the presence of diffuse idiopathic skeletal hyperostosis should always be investigated in patients with congestive heart failure who report stiffness of the spine or chronic back pain, especially in those undergoing exercise-based activities. Objective: To assess the prevalence of diffuse idiopathic skeletal hyperostosis and its relationship with vascular risk factors among patients with congestive heart failure. Design: Population-based cross-sectional study. Participants: A total of 584 consecutive patients admitted to a Rehabilitative Cardiology Unit. Methods: Chi-square Automatic Interaction Detector (CHAID) decision tree analysis was used to build a predictive model. Results: The mean age (standard deviation) of the study population was 68.1 years (standard deviation 12.3), and 77.7% of the subjects were men. The overall prevalence of diffuse idiopathic skeletal hyperostosis in the cohort was 49.8%. Logistic regression analysis showed that age was a predictor of diffuse idiopathic skeletal hyperostosis (odds ratio 1.034; 95% confidence interval: 1.021-1.047, p < 0.001), with increasing odds ratios for increasing age tertiles. The CHAID prediction model identified 2 age "buckets": ≤ 69 and > 69 years. Patients > 69 years had a diffuse idiopathic skeletal hyperostosis prevalence of 60.1%, compared with 39.2% among those ≤ 69 years. Notably, body mass index was a predictor of diffuse idiopathic skeletal hyperostosis in this younger subset of patients (p = 0.028), with 2 body mass index buckets, ≤ 23.3 and > 23.3 kg/m 2 , the latter showing more than twice the prevalence of diffuse idiopathic skeletal hyperostosis (43.2% vs 20%). Conclusion: Diffuse idiopathic skeletal hyperostosis is extremely frequent among patients with congestive heart failure, with age and body mass index being the strongest predictors.

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Subjects with diffuse idiopathic skeletal hyperostosis have an increased burden of coronary artery disease: An evaluation in the COPDGene cohort

Cited by 19 publications

References 29 publications

Pseudohypoparathyroidism mimicking cervical diffuse idiopathic skeletal hyperostosis with dysphagia: A case report and literature review

Pseudohypoparathyroidism mimicking cervical diffuse idiopathic skeletal hyperostosis with dysphagia: A case report and literature review

Cardiovascular disease in diffuse idiopathic skeletal hyperostosis (DISH): from theory to reality—a 10-year follow-up study

Diffuse idiopathic skeletal hyperostosis in subjects with congestive heart failure undergoing cardiac rehabilitation: A decision tree analysis

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