Osteoarthritis – ABC CARDIOL

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Editorial

Applying EASIX in Osteoarthritis. The Link between Inflammation and Cardiovascular Risk

Osteoarthritis (OA), long regarded as a mechanical wear-and-tear disease of the joints, is increasingly being reinterpreted in light of evidence identifying it as a chronic low-grade inflammatory disease. This shift is more than semantic; it fundamentally reshapes how we assess the systemic risks faced by these patients, particularly their cardiovascular risk (CVR). Given the growing recognition of endothelial dysfunction as a key manifestation of the inflammatory process involved in vascular event development, the pursuit of tools capable of detecting indicators of these underlying mechanisms is of substantial importance.

In this issue, we present a new application of the Endothelial Activation and Stress Index (EASIX) to predict CVR in OA patients. Originally developed for hematological conditions, particularly graft-versus-host disease (GVHD), EASIX integrates three widely available markers – LDH, serum creatinine, and platelet count – into a single index that reflects endothelial stress.^,

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Original Article

Association of Endothelial Activation and Stress Index with Risk of Cardiovascular Disease and All-cause Mortality in Patients with Osteoarthritis

Ruoyan Li et al. Chaoqun Feng Kexin Lin Nan Wang Xiaohong Fan

Abstract

Background

Osteoarthritis is a prevalent type of arthritis characterized by chronic degenerative changes in the musculoskeletal system, which can result in joint damage and chronic pain.

Objective

This study was to investigate the associations between the endothelial activation and stress index (EASIX) and the increased risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality among patients diagnosed with osteoarthritis.

Methods

The cohort study encompassed 2028 individuals aged 40-79 years with osteoarthritis, utilizing data from the National Health and Nutrition Examination Surveys (NHANES) database spanning the years 2007 to 2018. The univariate weighted logistic regression model and weighted Cox model were respectively established to screen possible confounders. A significance level of p < 0.05 was adopted for all statistical analyses.

Results

The study revealed an elevated risk of ASCVD in correlation with an increased log (EASIX) (Odds Ratio: 1.94, with 95% Confidence Interval:1.57-2.41). When compared to individuals with log (EASIX) -0.78 demonstrated a heightened risk of ASCVD (Odds Ratio: 2.31, with 95% Confidence Interval:1.68-3.18). A higher log (EASIX) value was also linked to an increased risk of mortality from all causes (Hazard Ratio: 1.59, with 95% Confidence Interval:1.14 -2.23). Among individuals diagnosed with osteoarthritis, those exhibiting log (EASIX)> -0.78 faced a greater risk of dying from any cause, as compared to patients with log (EASIX) <-1.29.

Conclusion

The presence of a high EASIX index was linked to an increased risk of ASCVD and all-cause mortality among patients with osteoarthritis.