Association of Diffuse Idiopathic Skeletal Hyperostosis with Vascular Calcification and Cardiovascular Disease — The International Society for the Study of the Lumbar Spine
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Association of Diffuse Idiopathic Skeletal Hyperostosis with Vascular Calcification and Cardiovascular Disease (#1217)

Ryosuke Hirota 1 , Mitsunori Yoshimoto 1 , Arihiko Tsukamoto 1 , Izaya Ogon 1 , Noriyuki Iesato 1 , Hiroyuki Takashima 2 , Toshihiko Yamashita 1
  1. Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Hokkaido, Japan
  2. Division of Radiology and Nuclear Medicine, apporo Medical University School of Medicine, Sapporo, Hokkaido, Japan

INTRODUCTION

Diffuse idiopathic skeletal hyperostosis (DISH) occurs mainly as an ossification form around the vertebrae and causes pseudoarthrosis and delayed neuropathy after vertebral fracture. It is known to be associated with obesity and metabolic abnormalities, but the cause is unknown, and the relationship with medical diseases is also largely unknown. We hypothesized that this disease is associated with vascular calcification and the occurrence of cardiovascular events.

METHODS

First, we randomly selected 400 patients who underwent surgery at the Department of Cardiovascular Surgery in our hospital from 2016 to 2008 (cardiovascular event group) and 400 patients who were transported to the Emergency Department for non-cardiovascular events during the same period (non-event group), respectively, and investigated the incidence of DISH. The presence or absence of DISH was assessed by CT imaging based on the criteria proposed by Resnick et al. Second, in the non-event group, we evaluated the degree of calcification in coronary arteries and aorta using coronary artery calcification score (CACS) and aortic calcification index (ACI) to determine the association with DISH incidence. We used workstation software, VINCENT, for image analysis.

RESULTS

The incidence of DISH was 30.2% in the cardiovascular event group and 14.1% in the non-event group. The incidence of DISH was 30.2% in the cardiovascular event group and 14.1% in the non-event group, and was higher in the cardiovascular event group. In terms of vascular calcification, DISH patients in the non-event group (39 patients) had CACS 673.2 ± 124.7 and ACI 9929.6 ± 1492.0, while those without DISH (237 patients) had CACS 174.2 ± 70.8 and ACI 3555.8 ± 545.0. The values were significantly higher in DISH cases.

DISCUSSION

The incidence of DISH was higher in patients with cardiovascular events, and patients with DISH had more calcification of coronary arteries and aorta. These results are important for understanding the pathophysiology and developmental mechanism of this disease. The findings may also be useful for early detection and treatment of untreated cardiovascular diseases.

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