High prevalence of subclinical atherosclerosis in psoriatic arthritis patients: a study based on carotid ultrasound
Rosario Ibáñez-Bosch 1 2 , Juliana Restrepo-Velez 3 , Miguel Medina-Malone 3 , Laura Garrido-Courel 3 , Inmaculada Paniagua-Zudaire 3 , Eduardo Loza-Cortina 3
Analyse the presence of subclinical atherosclerosis in psoriatic arthritis patients (PsA). A cross-sectional study of 53 patients with PsA and 53 controls matched for age and sex was designed.
Carotid intima-media thickness (IMT) and the presence of carotid plaques (CP) were assessed with carotid ultrasound. Data on cardiovascular (CV) risk factors were collected. Patients with PsA had a higher prevalence rate of obesity and tobacco smoking. CP were detected more frequently in patients with PsA than in controls with an OR of 4.15, 95% CI 1.4-12.1, which adjusted for smoking and those with history of CV disease gave an OR of 3.9, 95% CI 1.2-12.7, p = 0.026.
Carotid IMT was significantly higher in patients with PsA adjusted for age and tobacco smoking. According to ultrasound data, 30.2% of patients with PsA had carotid atherosclerosis (presence of CP and/or carotid IMT > 0.90 mm) compared with 9.4% of controls. The SCORE index (Systematic Coronary Risk Evaluation) underestimated the CV risk in these patients: most patients with CP had an intermediate CV risk. According to carotid ultrasound data, PsA patients have a high prevalence of subclinical atherosclerosis.
These results support the importance of screening for CV risk and to include carotid ultrasound in CV prevention strategies in these patients.
CITATION Rheumatol Int. 2017 Jan;37(1):107-112. doi: 10.1007/s00296-016-3617-x. Epub 2016 Nov 24