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

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

doi:10.1016/j.atherosclerosis.2019.05.030

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

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND AND AIMS: Diffuse idiopathic skeletal hyperostosis (DISH) is a common incidental finding on medical imaging and often thought to be benign. Our objective was to investigate whether DISH is associated with coronary artery disease as measured with the coronary artery calcification (CAC) score in a large cohort of current and former smokers.

METHODS: In a subset of subjects from the COPDGene study, DISH was scored by a minimum of two independent readers if there were four adjacent levels of flowing osteophytes and a third reader adjudicated discrepancies. CAC was calculated using a modified Agatston method. Associations of DISH with the presence and extent of CAC were analyzed with and without adjustment for COPD and known atherosclerotic risk factors, including age, sex, race, diabetes, hypertension, high cholesterol, body mass index and smoking.

RESULTS: DISH was present in 361 subjects (13.2%) from a total group of 2728. Median (interquartile range) Agatston was 81 (0-329) in DISH subjects compared to 0 (0-94 in subjects without DISH (p < 0.001). DISH prevalence was 8.8% in CAC = 0, 12.8% in CAC1-100, 20.0% in CAC100-400 and 24.7% in CAC.400. Subjects with DISH had a significantly higher risk of having coronary artery calcifications; OR [CI95%] 1.37[1.05-1.78] (p=0.019) after correction for age, gender, race, COPD and atherosclerotic risk factors.

CONCLUSIONS: Subjects with DISH, a common musculoskeletal disorder involving bone formation anterior to the spine, have an increased burden of coronary artery disease, and therefore DISH may be a more relevant incidental finding than commonly thought.

Original language	English
Pages (from-to)	24-29
Number of pages	6
Journal	Atherosclerosis
Volume	287
DOIs	https://doi.org/10.1016/j.atherosclerosis.2019.05.030
Publication status	Published - 1 Aug 2019

Keywords

Agatson score
Atherosclerosis
Calciumscore
Coronary artery disease
CT
DISH

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Oudkerk, S. F., Mohamed Hoesein, F. A. A., PThM Mali, W., Öner, F. C., Verlaan, J. J., de Jong, P. A., Kinney, G. L., Hokanson, J., Lynch, D., Silverman, E. K., Budoff, M. J., & Regan, E. A. (2019). Subjects with diffuse idiopathic skeletal hyperostosis have an increased burden of coronary artery disease: An evaluation in the COPDGene cohort. Atherosclerosis, 287, 24-29. https://doi.org/10.1016/j.atherosclerosis.2019.05.030

@article{aa03452634244abfaf298f846390e512,

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

abstract = "BACKGROUND AND AIMS: Diffuse idiopathic skeletal hyperostosis (DISH) is a common incidental finding on medical imaging and often thought to be benign. Our objective was to investigate whether DISH is associated with coronary artery disease as measured with the coronary artery calcification (CAC) score in a large cohort of current and former smokers.METHODS: In a subset of subjects from the COPDGene study, DISH was scored by a minimum of two independent readers if there were four adjacent levels of flowing osteophytes and a third reader adjudicated discrepancies. CAC was calculated using a modified Agatston method. Associations of DISH with the presence and extent of CAC were analyzed with and without adjustment for COPD and known atherosclerotic risk factors, including age, sex, race, diabetes, hypertension, high cholesterol, body mass index and smoking.RESULTS: DISH was present in 361 subjects (13.2%) from a total group of 2728. Median (interquartile range) Agatston was 81 (0-329) in DISH subjects compared to 0 (0-94 in subjects without DISH (p < 0.001). DISH prevalence was 8.8% in CAC = 0, 12.8% in CAC1-100, 20.0% in CAC100-400 and 24.7% in CAC.400. Subjects with DISH had a significantly higher risk of having coronary artery calcifications; OR [CI95%] 1.37[1.05-1.78] (p=0.019) after correction for age, gender, race, COPD and atherosclerotic risk factors.CONCLUSIONS: Subjects with DISH, a common musculoskeletal disorder involving bone formation anterior to the spine, have an increased burden of coronary artery disease, and therefore DISH may be a more relevant incidental finding than commonly thought.",

keywords = "Agatson score, Atherosclerosis, Calciumscore, Coronary artery disease, CT, DISH",

author = "Oudkerk, {Sytse F.} and {Mohamed Hoesein}, {Firdaus A.A.} and {PThM Mali}, Willem and {\"O}ner, {F. Cumhur} and Verlaan, {Jorrit Jan} and {de Jong}, {Pim A.} and Kinney, {Gregory L.} and John Hokanson and David Lynch and Silverman, {Edwin K.} and Budoff, {Matthew J.} and Regan, {Elizabeth A.}",

note = "Funding Information: The COPDGene {\textregistered} project is also supported by the COPD Foundation through contributions made to an Industry Advisory Board comprised of AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Pfizer, Siemens and Sunovion. Funding Information: The project described was supported by Award Number U01 HL089897 and Award Number U01 HL089856 from the National Heart, Lung, and Blood Institute . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. Publisher Copyright: {\textcopyright} 2019 Elsevier B.V.",

year = "2019",

month = aug,

day = "1",

doi = "10.1016/j.atherosclerosis.2019.05.030",

language = "English",

volume = "287",

pages = "24--29",

journal = "Atherosclerosis",

issn = "0021-9150",

publisher = "Elsevier",

}

Oudkerk, SF, Mohamed Hoesein, FAA, PThM Mali, W, Öner, FC , Verlaan, JJ , de Jong, PA, Kinney, GL, Hokanson, J, Lynch, D, Silverman, EK, Budoff, MJ & Regan, EA 2019, 'Subjects with diffuse idiopathic skeletal hyperostosis have an increased burden of coronary artery disease: An evaluation in the COPDGene cohort', Atherosclerosis, vol. 287, pp. 24-29. https://doi.org/10.1016/j.atherosclerosis.2019.05.030

TY - JOUR

T1 - Subjects with diffuse idiopathic skeletal hyperostosis have an increased burden of coronary artery disease

T2 - An evaluation in the COPDGene cohort

AU - Oudkerk, Sytse F.

AU - Mohamed Hoesein, Firdaus A.A.

AU - PThM Mali, Willem

AU - Öner, F. Cumhur

AU - Verlaan, Jorrit Jan

AU - de Jong, Pim A.

AU - Kinney, Gregory L.

AU - Hokanson, John

AU - Lynch, David

AU - Silverman, Edwin K.

AU - Budoff, Matthew J.

AU - Regan, Elizabeth A.

N1 - Funding Information: The COPDGene ® project is also supported by the COPD Foundation through contributions made to an Industry Advisory Board comprised of AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Pfizer, Siemens and Sunovion. Funding Information: The project described was supported by Award Number U01 HL089897 and Award Number U01 HL089856 from the National Heart, Lung, and Blood Institute . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. Publisher Copyright: © 2019 Elsevier B.V.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - BACKGROUND AND AIMS: Diffuse idiopathic skeletal hyperostosis (DISH) is a common incidental finding on medical imaging and often thought to be benign. Our objective was to investigate whether DISH is associated with coronary artery disease as measured with the coronary artery calcification (CAC) score in a large cohort of current and former smokers.METHODS: In a subset of subjects from the COPDGene study, DISH was scored by a minimum of two independent readers if there were four adjacent levels of flowing osteophytes and a third reader adjudicated discrepancies. CAC was calculated using a modified Agatston method. Associations of DISH with the presence and extent of CAC were analyzed with and without adjustment for COPD and known atherosclerotic risk factors, including age, sex, race, diabetes, hypertension, high cholesterol, body mass index and smoking.RESULTS: DISH was present in 361 subjects (13.2%) from a total group of 2728. Median (interquartile range) Agatston was 81 (0-329) in DISH subjects compared to 0 (0-94 in subjects without DISH (p < 0.001). DISH prevalence was 8.8% in CAC = 0, 12.8% in CAC1-100, 20.0% in CAC100-400 and 24.7% in CAC.400. Subjects with DISH had a significantly higher risk of having coronary artery calcifications; OR [CI95%] 1.37[1.05-1.78] (p=0.019) after correction for age, gender, race, COPD and atherosclerotic risk factors.CONCLUSIONS: Subjects with DISH, a common musculoskeletal disorder involving bone formation anterior to the spine, have an increased burden of coronary artery disease, and therefore DISH may be a more relevant incidental finding than commonly thought.

AB - BACKGROUND AND AIMS: Diffuse idiopathic skeletal hyperostosis (DISH) is a common incidental finding on medical imaging and often thought to be benign. Our objective was to investigate whether DISH is associated with coronary artery disease as measured with the coronary artery calcification (CAC) score in a large cohort of current and former smokers.METHODS: In a subset of subjects from the COPDGene study, DISH was scored by a minimum of two independent readers if there were four adjacent levels of flowing osteophytes and a third reader adjudicated discrepancies. CAC was calculated using a modified Agatston method. Associations of DISH with the presence and extent of CAC were analyzed with and without adjustment for COPD and known atherosclerotic risk factors, including age, sex, race, diabetes, hypertension, high cholesterol, body mass index and smoking.RESULTS: DISH was present in 361 subjects (13.2%) from a total group of 2728. Median (interquartile range) Agatston was 81 (0-329) in DISH subjects compared to 0 (0-94 in subjects without DISH (p < 0.001). DISH prevalence was 8.8% in CAC = 0, 12.8% in CAC1-100, 20.0% in CAC100-400 and 24.7% in CAC.400. Subjects with DISH had a significantly higher risk of having coronary artery calcifications; OR [CI95%] 1.37[1.05-1.78] (p=0.019) after correction for age, gender, race, COPD and atherosclerotic risk factors.CONCLUSIONS: Subjects with DISH, a common musculoskeletal disorder involving bone formation anterior to the spine, have an increased burden of coronary artery disease, and therefore DISH may be a more relevant incidental finding than commonly thought.

KW - Agatson score

KW - Atherosclerosis

KW - Calciumscore

KW - Coronary artery disease

KW - CT

KW - DISH

UR - http://www.scopus.com/inward/record.url?scp=85066845430&partnerID=8YFLogxK

U2 - 10.1016/j.atherosclerosis.2019.05.030

DO - 10.1016/j.atherosclerosis.2019.05.030

M3 - Article

C2 - 31181416

AN - SCOPUS:85066845430

SN - 0021-9150

VL - 287

SP - 24

EP - 29

JO - Atherosclerosis

JF - Atherosclerosis

ER -

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

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Keywords

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