The Presence of Diffuse Idiopathic Skeletal Hyperostosis (DISH) among Patients with High Burden of Cardiovascular Risk Factors: A Retrospective Study

Abstract

Background. DISH is a systemic condition characterized by ligamentous ossification of at least four contiguous thoracic vertebrae. Prior studies have shown an association between DISH and cardiovascular morbidity. Objective. To investigate the association between DISH, cardiovascular risk factors, and MACE (myocardial infarction, ischemic stroke, and CV mortality) in patients who underwent coronary angiography between 5/2014 and 4/2015 in Ha’Emek Medical Center through 7 years of retrospective follow-up. Methods. Two cohorts were studied retrospectively and were defined according to the status of the coronary artery as diagnosed in angiography at enrolment (obstructive vs. nonobstructive coronary heart disease). For the retrospective analysis, we added the status of DISH (according to Resnick’s criteria) and defined four cohorts as follows: CHD and DISH (group 1), CHD and no DISH (group 2), no CHD and DISH (group 3), and no CHD and no DISH (group 4). The four groups were followed up retrospectively for a median period of 7 years. Association between DISH and cardiovascular outcomes was studied. Results. 198 patients were included in the study. 100 of them had CHD, and 98 were without significant CHD. At enrolment, DISH was present in 44 patients of CHD group and in 35 of non-CHD (p=0.28 age and sex adjusted). Through the follow-up period, the presence of DISH was not found to be associated with death from any cause, cardiovascular death, ischemic stroke, and MACE. Within the group of non-CHD, there were two additional MI events in DISH (group 3) which was found to be statistically significant. Conclusion. Among patients with high burden of cardiovascular risk factors undergoing coronary angiography, the presence of DISH was not associated with an increased incidence of MACE.