Risk of acute coronary syndrome in patients with cervical spondylosis
What were the aims of the study?
Various studies in the past have described cervical spondylosis (CS), the degenerative changes in the cervical bones and ligaments contributing to degenerative cervical myelopathy, as associated with increased sympathetic nervous tone.
The sympathetic nervous system plays a role in controlling blood pressure, heart rate and various other aspects of our cardiovascular health. But part of its control structure also lies in close proximity to the cervical spine.
The authors noted that no research had been done to link the above statements, if CS does cause increased sympathetic activity, does this logically follow that CS causes an increased incidence of cardiovascular events?
With this in mind, the aim of the study was to determine if cervical spondylosis increased the risk of cardiovascular health issues, specifically acute coronary syndrome (ACS), which in common terms is a heart attack.
How was the study performed?
All the patients were followed up until they had a diagnosis of ACS, died, or the end of the research period occurred at the end of 2011. After this, the number of ACS events in each group were measured as a rate over the number of “person years”. This being the number of times a diagnosis of ACS was made for every year a patient lived.
In this paper, the incidence of ACS was measured as number of ACS/1000-person years. These were then compared between various groups to obtain a ratio, to determine the relative risk of ACS occurring in a person with CS compared to someone without ACS in a similar state of health.
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What were the main findings?
Looking in more detail at the patients with CS, for those with myelopathy the risk was slightly higher, increasing by 20% but interestingly, it seems treatment of CS has an effect in reducing ACS risk:
– Patients receiving spinal decompression surgery were less likely to have an ACS (27% reduction)
– Patients receiving rehabilitative therapy were less likely to have an ACS (33% reduction)
The statistical difference between the form of treatment for CS and reducing ACS risk was not significant.
How could cervical spondylosis cause acute coronary syndrome?
What can we take from this study?
There are a number of limitations to this study, and the actually increases in risk are relatively small. But it adds to the research of CSM and Cardiovascular disease, and once again shows the far reaching impacts of CSM.
M. Singh, I. Khurana, Z. Kundu, A. Aggarwal, Link of sympathetic activity with cardiovascular risk in patients of cervical spondylosis, Int. J. Clin. Exp. Pathol. 3 (2016) 41e44
M. Singh, I. Khurana, Z.S. Kundu, A. Aggarwal, Galvanic skin response in pa- tients with cervical spondylosis, IJHSR 6 (2016) 148e152.
 N. Marina, A.G. Teschemacher, S. Kasparov, A.V. Gourine, Glia, sympathetic activity and cardiovascular disease, Exp. Physiol. 101 (2016) 565e576,