Diffuse idiopathic skeletal hyperostosis in subjects with congestive heart failure undergoing cardiac rehabilitation:
Insights
Diffuse idiopathic skeletal hyperostosis (DISH) is common in heart failure patients, affecting nearly half of those studied. Age and body mass index are key predictors of DISH in this population.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic skeletal disease characterized by widespread calcification and ossification of ligaments and entheses.
- Congestive heart failure (CHF) is a complex clinical syndrome with significant morbidity and mortality.
- The association between DISH and cardiovascular risk factors, particularly in patients with CHF, warrants further investigation.
Purpose of the Study:
- To determine the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in patients diagnosed with congestive heart failure (CHF).
- To explore the relationship between DISH and established vascular risk factors within this patient cohort.
Main Methods:
- A population-based, cross-sectional study was conducted.
- 584 consecutive patients admitted to a Rehabilitative Cardiology Unit were included.
- Chi-square Automatic Interaction Detector (CHAID) decision tree analysis and logistic regression were employed to identify predictors.
Main Results:
- The prevalence of DISH among CHF patients was 49.8%.
- Age was a significant predictor of DISH (OR 1.034, p<0.001), with prevalence increasing in those aged 69 years and older (60.1%).
- Body mass index (BMI) was also a predictor in younger patients (<69 years), with BMI >23.3 kg/m² showing over double the prevalence of DISH (43.2% vs 20%).
Conclusions:
- Diffuse idiopathic skeletal hyperostosis is highly prevalent in patients with congestive heart failure.
- Age and body mass index emerged as the most significant predictors for DISH in this population.
- These findings highlight the importance of considering DISH in CHF patients and investigating potential shared pathophysiological mechanisms.
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/m2, 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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