From the Journals

Severe psoriasis linked to a higher risk for heart disease, study confirms


 

FROM THE JOURNAL OF INVESTIGATIVE DERMATOLOGY

TOPLINE:

In a large cross-sectional study, nearly one-third of patients with severe psoriasis met criteria for coronary microvascular dysfunction (CMD).

METHODOLOGY:

  • Prior studies with small sample sizes have shown that CMD predicts poor cardiovascular outcomes in patients with severe psoriasis.
  • In a prospective multicenter study, researchers enrolled 448 patients with moderate to severe psoriasis with no documented clinical cardiovascular disease who underwent transthoracic Doppler echocardiography to evaluate coronary microcirculation.
  • The outcome variable of interest was CMD, defined as a coronary flow rate of 2.5 mL or less.
  • The researchers used multivariable linear regression to model the associations of the characteristics of patients with psoriasis with CMD.

TAKEAWAY:

  • Of the 448 patients, 141 (31.5%) showed CMD.
  • Multivariable regression revealed four variables independently associated with CMD: higher Psoriasis Area Severity Index (PASI) score (per unit, odds ratio, 1.058; P < .001), duration of psoriasis (per year; OR, 1.046; P < .001), the presence of psoriatic arthritis (OR, 1.938; P = .015), and hypertension (OR, 2.169; P = .010).
  • An increase of 1 point in the PASI score and 1 year of psoriasis duration were associated with a 5.8% and a 4.6% increased risk for CMD, respectively.

IN PRACTICE:

“We should diagnose and actively search for microvascular dysfunction in patients with psoriasis, as this population is at particularly high risk,” the researchers wrote.

SOURCE:

Stefano Piaserico, MD, PhD, of the University of Padova (Italy), led the research. The study was published in the Journal of Investigative Dermatology.

LIMITATIONS:

A small proportion of patients in the study were being treated for psoriasis, and other tools for assessing CMD were not used, such as PET-CT and cardiovascular MRI.

DISCLOSURES:

The authors reported having no relevant financial disclosures.

A version of this article first appeared on Medscape.com.

Recommended Reading

Could risk stratifying methotrexate users lead to less frequent testing?
MDedge Dermatology
What factors cause multiple biologic failure in psoriasis?
MDedge Dermatology
Roflumilast cream appears safe, effective for children with psoriasis, researchers report
MDedge Dermatology
Study validates use of new psoriatic arthritis prediction tool
MDedge Dermatology
PsA biomarkers move researchers closer to predictive test
MDedge Dermatology
New evidence suggests genetic risk factors in hidradenitis suppurativa
MDedge Dermatology
Financial Insecurity Among US Adults With Psoriasis
MDedge Dermatology
Rheumatology trials seem vulnerable to unblinding: Report
MDedge Dermatology
Medicare announces 10 drugs targeted for price cuts in 2026
MDedge Dermatology
Effect of COVID-19 Vaccination on Disease Severity in Patients With Stable Plaque Psoriasis: A Cross-sectional Study
MDedge Dermatology