Diffuse idiopathic skeletal hyperostosis is associated with incident stroke in patients with increased cardiovascular risk. (13th November 2021)

• Record Type: Journal Article
• Authors: Harlianto, Netanja I; Oosterhof, Nadine; Foppen, Wouter; Hol, Marjolein E; Wittenberg, Rianne; van der Veen, Pieternella H; van Ginneken, Bram; Mohamed Hoesein, Firdaus A A; Verlaan, Jorrit-Jan; de Jong, Pim A; Westerink, Jan
• Is Part Of: Rheumatology. Volume 61:Number 7(2022)
• Page Start: 2867
• Page End: 2874
• Publication Date: 2021-11-13
• Subjects: DISH -- cardiovascular events -- cardiovascular disease -- mortality -- ischaemic stroke -- myocardial infarction -- MACE; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keab835
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: Earlier retrospective studies have suggested a relation between DISH and cardiovascular disease, including myocardial infarction. The present study assessed the association between DISH and incidence of cardiovascular events and mortality in patients with high cardiovascular risk. Methods: In this prospective cohort study, we included 4624 patients (mean age 58.4 years, 69.6% male) from the Second Manifestations of ARTerial disease cohort. The main end point was major cardiovascular events (MACE: stroke, myocardial infarction and vascular death). Secondary endpoints included all-cause mortality and separate vascular events. Cause-specific proportional hazard models were used to evaluate the risk of DISH on all outcomes, and subdistribution hazard models were used to evaluate the effect of DISH on the cumulative incidence. All models were adjusted for age, sex, body mass index, blood pressure, diabetes, non-HDL cholesterol, packyears, renal function and C-reactive protein. Results: DISH was present in 435 (9.4%) patients. After a median follow-up of 8.7 (IQR 5.0–12.0) years, 864 patients had died and 728 patients developed a MACE event. DISH was associated with an increased cumulative incidence of ischaemic stroke. After adjustment in cause-specific modelling, DISH remained significantly associated with ischaemic stroke (HR 1.55; 95% CI: 1.01, 2.38), but not with MACE (HR 0.99; 95% CI: 0.79, 1.24), myocardial infarction (HR 0.88; 95% CI: 0.59, 1.31), vascular death (HR 0.94; 95% CI: 0.68, 1.27) or all-cause mortality (HR 0.94; 95% CI: 0.77, 1.16). Conclusion: The presence of DISH is independently associated with an increased incidence and risk for ischaemic stroke, but not with MACE, myocardial infarction, vascular death or all-cause mortality.