Risk factors and assessment of subclinical atherosclerosis in patients with psoriatic arthritis

Objective

To understand the prevalence of subclinical atherosclerosis (SCA) in psoriatic arthritis (PsA) patients; to explore the correlation between PsA combined with SCA and traditional cardiovascular risk factors and disease activity; to compare the role of Framingham Risk Score (FRS) and atherosclerotic cardiovascular disease (ASCVD) scores.

Methods

We included 50 PsA patients who met the CASPAR classification criteria, 50 diabetes patients and 50 healthy people. Clinical data were collected from all patients, minimal disease activity (MDA), disease activity index for psoriatic arthritis (DAPSA), ASCVD, FRS were assessed in patients with PsA, and carotid artery intima–media thickness was measured.

Results

The prevalence of SCA in PsA patients was significantly higher than that in healthy controls (44% vs 24%, P < 0.05). Smoking, drinking, ASCVD, FRS were the risk factors of PsA with SCA (P < 0.05). Psoriasis (PsO) duration, PtGA, VAS and DAPSA were the risk factors for PsA with SCA (P < 0.05). FRS and ASCVD scores underestimated SCA risk in PsA patients.

Conclusion

Compared with healthy controls, patients with PsA have higher prevalence of SCA. High DAPSA is a risk factor for PsA with SCA. Carotid ultrasound can monitor SCA in patients with PsA, improve stratification of cardiovascular risk.