Modern determinants of cardiovascular risk factors in patients with psoriatic arthritis: Relation to disease activity and severity

Abstract

Aim of the work

To evaluate the frequency of cardiovascular (CV) risk factors in psoriatic arthritis (PsA) patients.

Patients and methods

The study included 97 PsA patients and 30 control. Lipid profile and serum homocysteine level were assessed. The endothelium-dependent vasodilation (EDVD) evaluated. The QRISK-3 scale was used to assess CV risk. Disease activity PsA (DAPSA) and psoriasis area and severity index (PASI) were recorded.

Results

Reduced EDVD (<10 %) was significantly more frequent in PsA compared to control (75.3 % vs. 6.7 %, p < 0.001), with significant differences in lipid profile (p < 0.001), homocysteine (p < 0.001), QRISK (p < 0.001), CRP (p < 0.001), DAPSA (p < 0.001), and disease duration (p < 0.001) between PsA patients with reduced and normal EDVD. Average CV risk was 7.7 times higher than in control, and the classical risk factors did not account for the reduced EDVD. Linear regression analysis identified disease duration (β 0.5; OR 1.65, p < 0.001) and disease activity (β 0.09; OR 1.09, p < 0.001) as significant predictors of CV risk in PsA patients. The predictive accuracy of DAPSA (sensitivity 69 %, specificity 86.4 %, 95 % CI: 0.7–0.9; p < 0.001) and disease duration (sensitivity 91 %, specificity 55 %, 95 % CI: 0.95–1; p < 0.001) for CV risk was determined.

Conclusion

A heightened CV risk in PsA patients is highlightened independent of traditional risk factors. The significance of disease activity and disease duration as robust predictors of CV risk in PsA patients is emphasized. The data on hyperhomocysteinemia and its association with endothelial dysfunction emphasize the intricate link between PsA, homocysteine levels, and increased CV risk.