PsA associated with increased prevalence/severity of coronary atherosclerosis

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Takeaway
  • Patients with psoriatic arthritis (PsA) had increased prevalence/severity of coronary atherosclerosis compared with control patients.
  • Disease duration increased the risk.
Why this matters
  • First large cohort study to compare prevalence, burden, and severity of coronary atherosclerosis in patients with PsA vs control patients.
Study design
  • 90 patients with PsA attending the outpatient clinic of the Prince of Wales Hospital (PWH) recruited.
  • Control patients were 240 age- and sex-matched individuals without known cardiovascular disease evaluated for coronary atherosclerosis with coronary CT angiography (CCTA) between 2010 and 2016 selected from the PWH database.
  • Funding: Health and Medical Research Fund.
Key results
  • Calcified plaque (CP), mixed plaque (MP), noncalcified plaque (NCP), and combined MP/NCP were more prevalent in patients with PsA than in control patients.
  • When all variables adjusted, PsA was an independent risk factor for all varieties of coronary plaque.
  • 60% of patients with PsA had at least 1 coronary plaque vs 35% of control patients.
  • Prevalence of CP, NCP, and MP/NCP in patients with PsA doubled that of control patients.
  • Prevalence of MP in patients with PsA vs control patients almost tripled. 
  • Duration of disease, age ≥55 y, and being male associated with greater plaque risk in patients with PsA.
Limitations
  • Control patients selected retrospectively.
  • Some clinical information, such as BMI, was not available.