The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone (original) (raw)
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Subclinical atherosclerosis in psoriatic arthritis: a case-control study
The Journal of rheumatology, 2008
To investigate the prevalence of subclinical atherosclerosis among patients with psoriatic arthritis (PsA). Forty patients with PsA were enrolled. Controls were matched by age, sex, and atherosclerotic risk factors. All patients and controls underwent duplex scan of the carotid arteries. Carotid intima-media thickness (IMT) was evaluated and the presence of atherosclerotic plaques was recorded. The plaques were graded and carotid plaque index was calculated. Patients with PsA had a higher IMT (mean +/- standard deviation, 1.04 +/- 0.35 mm vs 0.88 +/- 0.29 mm in controls; p = 0.03), and had a higher carotid plaque index than did matched controls (2.3 +/- 2.6, compared to 1.12 +/- 2.09; p = 0.03). Multivariate analysis demonstrated that PsA status as well as age and triglyceride levels were associated with the presence of carotid plaque. Other traditional risk factors were more prevalent among patients with PsA; however, they were not statistically significant. Our study demonstrates ...
The Open Dermatology Journal
Introduction: Psoriasis and Psoriatic Arthritis (PsA) are chronic diseases with a number of complications that, among others, may include alterations in the cardio-vascular system. Methods: The aim of this study was to evaluate the risk of Cardiovascular Diseases (CVD) in patients with psoriasis and psoriatic arthritis between the ages of 30-50. The research covered 95 outpatients and inpatients: 51 with plaque psoriasis (23 women and 28 men) and 44 with psoriasis and psoriatic arthritis (16 women and 28 men). The risk of cardio-vascular incident was evaluated with the use of the Framingham algorithm covering the age, total cholesterol, HDL cholesterol, blood pressure, the habit of smoking and diabetes. The 10-year risk of the occurrence of a cardio-vascular incident was higher in patients with psoriatic arthritis than in patients with plaque psoriasis (9,9% vs6,2%). A high risk of cardio-vascular events was observed in 35% men with psoriatic arthritis in comparison to 11% men with ...
Arthritis & Rheumatism, 2007
To assess the presence of subclinical atherosclerosis in patients with psoriatic arthritis (PsA) without clinically evident atherosclerosis or its complications, and to assess whether demographic or clinical factors affect the development of atherosclerotic disease in a series of patients with PsA attended to in a community hospital. Methods. Fifty-nine patients with PsA who fulfilled the Moll and Wright criteria were recruited from Hospital Xeral-Calde (Lugo, Spain). Patients seen during the period of recruitment who had classic cardiovascular risk factors or had experienced cardiovascular or cerebrovascular events were excluded. Fifty-nine healthy matched controls were also studied. Carotid artery intima-media thickness (IMT) and carotid plaques were measured in the right common carotid artery. The study was performed using high-resolution B-mode ultrasound.
Cardiovascular Risk in Patients with Psoriatic Arthritis
International Journal of Rheumatology, 2012
Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. In addition to skin and joint involvement, there is increasing evidence suggesting that patients with PsA also have an increase in risk of clinical and subclinical cardiovascular diseases, mostly due to accelerating atherosclerosis. Both conventional and nonconventional cardiovascular risk factors contribute to the increased cardiovascular risk in PsA. Chronic inflammation plays a pivotal role in the pathogenesis of atherosclerosis in PsA, acting independently and/or synergistically with the conventional risk factors. In this paper, we discuss the current literature indicating that patients with PsA are at risk of cardiovascular diseases.
Journal of Translational Medicine, 2016
Background: Psoriasis is a chronic inflammatory disease of the skin and joints that may also have systemic inflammatory effects, including the development of cardiovascular disease (CVD). Multiple epidemiologic studies have demonstrated increased rates of CVD in psoriasis patients, although a causal link has not been established. A growing body of evidence suggests that sub-clinical systemic inflammation may develop in psoriasis patients, even from a young age. We aimed to evaluate the prevalence of atherosclerosis and identify specific clinical risk factors associated with early vascular inflammation. Methods: We conducted a cross-sectional study of a tertiary care cohort of psoriasis patients using coronary artery calcium (CAC) score and carotid intima-media thickness (CIMT) to detect atherosclerosis, along with high sensitivity C-reactive protein (hsCRP) to measure inflammation. Psoriasis patients and controls were recruited from our tertiary care dermatology clinic. Presence of atherosclerosis was defined using validated numeric values within CAC and CIMT imaging. Descriptive data comparing groups was analyzed using Welch's t test and Pearson Chi square tests. Logistic regression was used to analyze clinical factors associated with atherosclerosis, and linear regression to evaluate the relationship between psoriasis and hsCRP. Results: 296 patients were enrolled, with 283 (207 psoriatic and 76 controls) having all data for the hsCRP and atherosclerosis analysis. Atherosclerosis was found in 67.6 % of psoriasis subjects versus 52.6 % of controls; Psoriasis patients were found to have a 2.67-fold higher odds of having atherosclerosis compared to controls [95 % CI (1.2, 5.92); p = 0.016], after adjusting for age, gender, race, BMI, smoking, HDL and hsCRP. In addition, a non-significant trend was found between HsCRP and psoriasis severity, as measured by PASI, PGA, or BSA, again after adjusting for confounders. Conclusions: A tertiary care cohort of psoriasis patients have a high prevalence of early atherosclerosis, increased hsCRP, and psoriasis remains a risk factor for the presence of atherosclerosis even after adjustment of key confounding clinical factors. Psoriasis may contribute to an accelerated systemic inflammatory cascade resulting in increased risk of CVD and CV events.
Prevalence and extent of subclinical atherosclerosis in patients with psoriasis
Journal of Internal Medicine, 2012
Objective. Patients with psoriasis are prone to premature atherosclerosis and increased risk of cardiovascular disease events. However, the prevalence and extent of atherosclerosis in patients with psoriasis are unknown. Design. A cross-sectional study. Setting and subjects. The prevalence and extent of coronary and carotid atherosclerosis were compared in 70 patients with psoriasis (46 ± 9 years, 71% male) without known cardiovascular disease or joint involvement and 51 age-and gendermatched healthy control subjects (45 ± 7 years, 71% male). Systemic inflammation was assessed by the level of high-sensitivity C-reactive protein (hs-CRP). Coronary atherosclerosis was determined by the coronary calcification score (CCS) measured by multi-detector computed tomography. Carotid atherosclerosis was assessed by high-resolution ultrasound-derived carotid intimamedia thickness (cIMT). Results. Patients with psoriasis had a higher prevalence of coronary atherosclerosis (CCS > 0; 28.6% vs. 3.9%, P < 0.01), and a higher degree of coronary atherosclerosis estimated by the mean CCS (67.4 ± 349.2 vs. 0.5 ± 3.0, P < 0.05) compared with controls. Similarly, cIMT was significantly greater in patients with psoriasis than in control subjects (0.73 ± 0.11 mm vs. 0.67 ± 0.08 mm, P < 0.01). Multiple logistic regression revealed that psoriasis [odd ratio (OR): 10.54, 95% confidence interval (CI) 1.89-58.67, P < 0.01] and serum total cholesterol level (OR 2.10, 95% CI 1.01-4.37) were associated with the presence of coronary atherosclerosis (CCS > 0). By contrast, only age was independently associated with increased cIMT. Amongst participants with no traditional cardiovascular disease risk factors, hs-CRP level was higher in patients with psoriasis than in controls. Conclusion. The present results demonstrate earlyonset, diffuse arterial atherosclerosis in coronary and carotid arteries in patients with psoriasis, but not in age-and gender-matched control subjects. Low-grade inflammation could explain the presence of premature atherosclerosis in patients with psoriasis.
Annals of the rheumatic diseases, 2017
To evaluate coronary atherosclerosis in patients with psoriatic arthritis (PsA) and control subjects using coronary CT angiography (CCTA). Ninety consecutive patients with PsA (male: 56(62.2%); 50.3±11.1 years) were recruited. 240 controls (male: 137(57.1%); 49.6±10.7 years) without known cardiovascular (CV) diseases who underwent CCTA due to chest pain and/or multiple CV risk factors were recruited for comparison. Patients with PsA and controls were matched in age, gender and traditional CV risk factors (all p>0.2). The prevalence of overall plaque (54(60%)/84(35%), p<0.001), calcified plaque (CP) (29(32%)/40(17%), p=0.002), mixed plaque (MP) (20(22%)/18(8%), p<0.001), non-calcified plaque (NCP) (39(43%)/53(22%), p<0.001) and combined MP/NCP (46(51%)/62(26%), p<0.001) were all significantly higher in patients with PsA. Three-vessel disease was diagnosed in 12(13%) patients with PsA and 7(3%) controls (p<0.001), while obstructive plaques (>50% stenosis) were obs...
… Derneği arşivi: Türk …, 2012
Objectives: Systemic inflammation plays an important role in the pathogenesis of atherosclerosis in psoriasis patients. Therefore, persistent skin inflammation in psoriasis patients may contribute to the development of premature atherosclerosis, as it occurs in rheumatoid arthritis and systemic lupus erythematosus. We aimed to evaluate the relationship between subclinical atherosclerosis and psoriasis by using pulse wave velocity (PWV) and the measurement of carotid intima media thickness (CIMT) in psoriatic patients.
Cardiovascular risk in psoriatic arthritis - a cross-sectional study
Maedica, 2014
OBJECTIVES The present study aims to estimate long term cardiovascular risk in psoriatic arthritis (PsA) patients and to identify clinical and/or laboratory features which influence this risk. OUTCOMES The PsA group included 44 males and 59 females (p = 0.167) with an average age of 52 years (23-80). SCORE was significantly correlated with age of onset, BMI, triglycerides, FPG. Among these patients, males, smokers, those with axial involvement, with IHT, with AHT and those not treated with glucocorticoids had a significantly higher SCORE. The subgroup of 56 PsA women, age-matched with 56 normal women, had a significantly higher SCORE, even after controlling for covariates. CONCLUSIONS Cardiovascular risk of PsA patients estimated on SCORE charts correlates with metabolic clinical and laboratory features and is associated with classical cardiovascular risk factors. The axial involvement in PsA is associated with a higher cardiovascular risk when compared to non-axial PsA. Women with ...