A comparison of disease impact according to the cardiometabolic risk profile in psoriatic arthritis (original) (raw)
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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 ...
Where borders meet: Psoriasic arthritis and the cardiovascular risk
Romanian Journal of Rheumatology
Objective: we aimed to estimate the long-term global cardiovascular risk (GCVR) in patients with psoriatic arthritis (PsA) and to identify factors correlated with this risk among traditional and non-traditional risk factors. Material and method: cross-sectional observational study enrolling 45 consecutive patients with PsA without known atherosclerotic disease or heart failure, attending an outpatient rheumatology department over 12 months. Disease-related parameters (clinical phenotype, inflammation tests, type of medication), traditional cardiovascular risk factors (smoking, obesity, dyslipidemia, hypertension, diabetes) and 10-year GCVR (Framingham Heart Study online platform) were collected in all patients according to a predefined protocol. Results: 57.77% of patients were female, with a mean age of 52.1 years; hypertension (46.66%), dyslipidemia and current smoking (20% each) were reported as main traditional cardiovascular risk factors in our cohort. 46.67% patients presented...
Medicina
Background and objectives: Psoriatic arthritis (PsA) is associated with several comorbidities, including among others an increased risk of cardiovascular (CV) disease, atherosclerosis, metabolic syndrome, hypertension dyslipidemia, and diabetes. The purpose of the present study was to determine how the number of CV risk factors correlates with disease related data such as disease activity. Materials and Methods: Cross-sectional study that encompassed 305 patients who fulfilled the CASPAR criteria for PsA were assessed for lipid profile, disease activity measurements, and the presence of six traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, chronic kidney disease, and smoking status). A multivariable regression analysis, adjusted for age, sex, and disease duration, was performed to evaluate if the number of classic CV risk factors was independently related with specific features of the disease, including disease activity. Results: Disease duration w...
Cardiovascular Risk Markers and Major Adverse Cardiovascular Events in Psoriatic Arthritis Patients
Reviews on recent clinical trials, 2018
Psoriatic arthritis is a chronic inflammatory arthropathy that affects 14%-30% of patients with skin and/or nail psoriasis and leading to severe physical limitations and disability. It has been included in the group of spondyloarthropathy with which it shares clinical, radiologic, and serologic features in addition to familial and genetic relationship. Beyond skin and joint involvement, psoriatic arthritis is characterized by a high prevalence of extra-articular manifestation and comorbidities, such as autoimmune, infectious and neoplastic diseases. In particular, an increased risk of cardiovascular comorbidity has been observed in psoriatic arthritis patients. The evidence regarding cardiovascular risk factors and biomarkers in psoriatic arthritis was extensively reviewed, including the contribution of obesity, metabolic syndrome, diabetes, hypertension, dyslipidemia and thrombosis/hemostasis abnormalities. Psoriatic arthritis is associated with a significantly increased risk of ca...
Arthritis Care & Research, 2011
To determine whether the presence of psoriatic arthritis (PsA) is associated with greater comorbidity, in particular cardiovascular morbidity, compared to psoriasis without arthritis. Methods. Six hundred eleven patients with PsA were recruited from the University of Toronto Psoriatic Arthritis Clinic and 449 psoriasis without arthritis patients were recruited from the University of Toronto Psoriasis Cohort. The clinical database was used to identify the prevalence of cardiovascular and other comorbidities in both PsA and psoriasis without arthritis patients. Univariate and multivariate logistic regression analyses were conducted to estimate odds ratios (ORs), comparing the odds of ever having a given comorbid disease in PsA patients with those in psoriasis without arthritis patients. Covariates included age, sex, education, smoking status, severity and duration of psoriasis, medication status, and other comorbidities. Results. The prevalence of hypertension, obesity, hyperlipidemia, type 2 diabetes mellitus, and at least 1 cardiovascular event in PsA patients was 37.1%, 30.0%, 20.7%, 12.0%, and 8.2%, respectively. This was significantly higher than in psoriasis without arthritis patients, with unadjusted ORs ranging from 1.54 to 2.59. In the multivariate analyses, hypertension remained significantly elevated (adjusted OR 2.17). PsA was also significantly associated with infections not treated with antibiotics (presumably viral), neurologic conditions, gastrointestinal disorders, and liver disease (adjusted ORs 2.83, 4.76, 21.53, and 7.74, respectively). Infections treated with antibiotics and depression/anxiety were relatively common in PsA, with a prevalence of 30.5% and 20.7%, respectively. However, this was not significantly different from psoriasis without arthritis after multivariate adjustments. Conclusion. The results suggest that inflammatory joint disease may play a role in both cardiovascular and noncardiovascular morbidity in PsA.
Arthritis care & research, 2017
To examine the prevalence and incidence of cardiovascular (CV) risk factors, including hypertension, hyperlipidemia, diabetes mellitus (DM), and obesity among patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA) compared to the general population, and to examine the treatment of incident CV risk factors in PsA and RA compared to controls. A cohort study was conducted within The Health Improvement Network, a medical record database in the UK, using data from 1994 to 2014. Patients ages 18-89 years with PsA or RA were matched to controls on practice and start date. The prevalence and incidence of CV risk factors identified by diagnostic codes were calculated. Cox proportional hazards models were used to examine the relative incidence of these CV risk factors. Finally, pharmacologic therapies for incident CV risk factors were examined. Study subjects included patients with PsA (n = 12,548), RA (n = 53,215), and controls (n = 389,269). The prevalence of all CV risk fact...
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 ...
Cardiovascular Risk in Psoriatic Arthritis: Search for New Biological Markers
Psoriasis Forum, 2010
Objective We investigated the relationships between the risk for coronary heart disease (CHD), psoriatic arthritis activity, and red blood cell aggregation (RBCA). Methods Our study comprised 130 patients with psoriatic arthritis (mean age, 41.7 ± 9.8) whose mean duration of psoriatic arthritis was 7 (IQ-range, 2.5–13) years and disease activity score (DAS) was 3.86 (IQ-range 2.72–5.14). We measured psoriatic arthritis DAS, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), time to formation of linear aggregates formation (T1 [s]), strength of the largest aggregates (la2.5[%]), hydrodynamic strength of aggregates (β [s−1]), velocity of aggregates formation (Kt [r.u.]), relative risk of CHD (RR CHD), and 10-year absolute risk (AR) of total and hard CHD in all patients. Statistical analysis was performed with Spearman correlation (R). Results Significant correlations were found between RBCA (T1/la2.5 /Kt) and DAS (R = −0.32/0.32/0.33), CRP (R = −0.34/0.41/0.47), and ESR (...
Rheumatology (Oxford, England), 2008
Objective. To examine the distribution of traditional and novel risk factors of cardiovascular disease (CVD) in patients with PsA compared with healthy controls. Methods. We compared risk factors for CVD between 102 consecutive PsA patients and 82 controls, adjusting for BMI. We also assessed the role of inflammation on the CVD risk factor by using a BMI and high-sensitivity CRP (hsCRP)-adjusted model. Results. The BMI of PsA patients were significantly higher than healthy controls. After adjusting for the BMI, PsA patients still have a higher prevalence of diabetes mellitus (DM) [odds ratio (OR) 9.27, 95% CI 2.09, 41.09) and hypertension (OR 3.37, 95% CI 1.68, 6.72), but a lower prevalence of low high density lipoprotein (HDL) cholesterol (OR 0.16, 95% CI 0.07, 0.41). PsA patients have significantly increased systolic and diastolic blood pressures, insulin resistance and inflammatory markers (hsCRP and white cell count) compared to controls. PsA patients have higher HDL cholesterol and apolipoprotein (Apo) A1 levels; and lower total cholesterol (TC) and low density lipoprotein cholesterol levels; and a lower TC/HDL ratio. However, the Apo B level (P < 0.05), and the Apo B/Apo A1 ratio (P ¼ 0.07) were higher in PsA patients. Further adjustment for hsCRP level rendered the differences in the prevalence of hypertension and DM; the TC, and sugar levels; and white cell count non-significant between the two groups; while the differences in other parameters remained significant. Conclusion. These data support the hypothesis that PsA may be associated with obesity, hypertension, dyslipidaemia and insulin resistance because of the shared inflammatory pathway.