Susceptibility to Atherosclerosis in Patients with Psoriasis and Psoriatic Arthritis as Determined b
Journal of Pan-Arab League of Dermatologists
Vol. 20, No. 1, February 2009 Page 159- 172
Susceptibility to Atherosclerosis in Patients with Psoriasis and PsoriaticArthritis as Determined by Increased Carotid Artery Intima-MediaThickness
Sahar S Youssef*, Shereen Hosny**, Iman Bakr*** and Amr Youssef***
Departments of Dermatology, Andrology & Venereology*, Rheumatology-Internal Medicine**, Community,
Environmental & Occupational Medicine*** and Cardiology****, Faculty of Medicine, Ain Shams University
Abstract
Background: Previous studies demonstratedthat psoriasis patients have an increased frequencyof cardiovascular co-orbiditiesdue toincreased risk of atherosclerosis. In this studywe analyzed the susceptibility to atherosclerosisof patients with psoriasisand psoriatic arthritis(PsA) by determining the common carotid arteriesintima media thickness CCA-IMT, usinghigh-esolution ultrasonography
Objectives: To access the prevalence of subclinicalatherosclerosis in psoriasis and psoriaticarthritispatients, with low-risk cardiovascularfactors compared with healthy controls, and toidentify the clinical and biological makersof inflammationin this patient population.
Methods: Forty-seven patients with psoriasiswithout joint affection and forty-sevenpatientswith psoriatic arthritis were enrolled in thisstudy after exclusion of traditional cardiovascularrisk factors andcardiovascular diseases.Forty-seven age and sex matched healthy controlswere included. The average carotid intima-mediathickness (IMT) was measured in thecommon carotid artery using high-resolution Bmodeultrasound. Disease activity,severity, andinflammatory markers were ascertained in allpatients.
Results: Patients with psoriasis and psoriaticarthritis (PsA)had a high prevalence of subclinicalatherosclerosis as determined by increasedIMT than did matched controls. PsApatientsexhibited greater carotid artery IMTthan psoriatic patients and controls with mean± SD of 0.96 ± 0.32, 0.61 ± 0.15, and0.53 ±0.10 respectively. Linear regression analysisshowed that ESR and age in the psoriatic groupand hsCRP and totalcholesterol in the psoriatic-arthiritis group were the mostly significantcorrelated variables to IMT.
Conclusion: The present studydemonstratesthat patients with psoriasis and PsA withoutknown cardiovascular risk factors have an increasedprevalence of subclinical atherosclerosis.Carotid IMT can identify patients with subclinicalatherosclerosis who need special attention,strict control and may benefit from early
intervention.
Journal of Pan-Arab League of Dermatologists
Vol. 20, No. 1, February 2009 Page 159- 172
Susceptibility to Atherosclerosis in Patients with Psoriasis and PsoriaticArthritis as Determined by Increased Carotid Artery Intima-MediaThickness
Sahar S Youssef*, Shereen Hosny**, Iman Bakr*** and Amr Youssef***
Departments of Dermatology, Andrology & Venereology*, Rheumatology-Internal Medicine**, Community,
Environmental & Occupational Medicine*** and Cardiology****, Faculty of Medicine, Ain Shams University
Abstract
Background: Previous studies demonstratedthat psoriasis patients have an increased frequencyof cardiovascular co-orbiditiesdue toincreased risk of atherosclerosis. In this studywe analyzed the susceptibility to atherosclerosisof patients with psoriasisand psoriatic arthritis(PsA) by determining the common carotid arteriesintima media thickness CCA-IMT, usinghigh-esolution ultrasonography
Objectives: To access the prevalence of subclinicalatherosclerosis in psoriasis and psoriaticarthritispatients, with low-risk cardiovascularfactors compared with healthy controls, and toidentify the clinical and biological makersof inflammationin this patient population.
Methods: Forty-seven patients with psoriasiswithout joint affection and forty-sevenpatientswith psoriatic arthritis were enrolled in thisstudy after exclusion of traditional cardiovascularrisk factors andcardiovascular diseases.Forty-seven age and sex matched healthy controlswere included. The average carotid intima-mediathickness (IMT) was measured in thecommon carotid artery using high-resolution Bmodeultrasound. Disease activity,severity, andinflammatory markers were ascertained in allpatients.
Results: Patients with psoriasis and psoriaticarthritis (PsA)had a high prevalence of subclinicalatherosclerosis as determined by increasedIMT than did matched controls. PsApatientsexhibited greater carotid artery IMTthan psoriatic patients and controls with mean± SD of 0.96 ± 0.32, 0.61 ± 0.15, and0.53 ±0.10 respectively. Linear regression analysisshowed that ESR and age in the psoriatic groupand hsCRP and totalcholesterol in the psoriatic-arthiritis group were the mostly significantcorrelated variables to IMT.
Conclusion: The present studydemonstratesthat patients with psoriasis and PsA withoutknown cardiovascular risk factors have an increasedprevalence of subclinical atherosclerosis.Carotid IMT can identify patients with subclinicalatherosclerosis who need special attention,strict control and may benefit from early
intervention.