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Epicardial adipose tissue and coronary artery calcification in psoriasis patients
T Torres1,2, N Bettencourt3, D Mendonça4
1Department of Dermatology, Centro Hospitalar do Porto, Porto, Portugal.
Insights
Psoriasis patients have increased epicardial adipose tissue (EAT) volume, independent of abdominal fat. This finding suggests EAT may contribute to the elevated cardiovascular disease risk in psoriasis.
Area of Science:
- Cardiology
- Dermatology
- Inflammation Research
Background:
- Psoriasis is linked to cardiovascular disease (CVD) and metabolic issues.
- Systemic inflammation and traditional risk factors don't fully explain increased CVD risk in psoriasis.
- Epicardial adipose tissue (EAT) surrounding the heart may drive coronary artery disease via local inflammation.
Purpose of the Study:
- Compare EAT volumes in psoriasis patients and controls using MDCT.
- Assess if EAT differences are independent of abdominal visceral fat (AVF).
- Examine the relationship between EAT, subclinical atherosclerosis, and cardiometabolic risk markers in psoriasis patients.
Main Methods:
- 100 severe psoriasis patients (no CVD) and 202 controls underwent MDCT.
- Assessed EAT volume and AVF.
- Quantified coronary artery calcification (CAC).
Main Results:
- Psoriasis patients had significantly higher EAT volume (15.2 mL average increase) than controls, independent of age, sex, and AVF.
- Psoriasis patients showed a 2.52-fold increased risk of subclinical atherosclerosis after adjusting for traditional risk factors.
- Within psoriasis patients, EAT volume correlated with subclinical atherosclerosis, independent of age, sex, psoriasis duration, traditional risk factors, and AVF.
Conclusions:
- Psoriasis is associated with increased EAT volume, independent of visceral abdominal fat.
- Psoriasis patients exhibit higher rates of subclinical atherosclerosis.
- EAT volume is independently linked to coronary artery calcification in psoriasis patients, suggesting it's a key contributor to their heightened cardiovascular risk.
Background:
Psoriasis is a chronic, immune-mediated disease associated with several cardio-metabolic comorbidities, accelerated atherosclerosis and cardiovascular disease (CVD). Other causes beyond systemic inflammation and traditional cardiovascular risk factors (CVRF) may be implicated in the increased risk of CVD observed in these patients. Epicardial adipose tissue (EAT), a type of visceral adipose tissue surrounding the heart and coronary vessels has been implicated in the development of coronary artery disease, by endocrine mechanisms, but particularly by local inflammation.
Objective:
To compare EAT volumes in psoriasis patients and controls using multidetector computed tomography (MDCT) and to analyse if eventual differences were independent from abdominal visceral adiposity; to determine, within psoriasis patients, its relation with subclinical atherosclerosis and other markers of cardiometabolic risk.
Methods:
One hundred patients with severe psoriasis, without CVD underwent MDCT, with EAT and abdominal visceral fat (AVF) assessment and coronary artery calcification (CAC) quantification and were compared with 202 control patients.
Results:
EAT volume was increased in psoriasis patients compared to control subjects, independently from age, sex and AVF, being, on average, 15.2 ± 4.41 mL higher (95% CI: 6.5-26.0, P = 0.001) than in controls. Moreover, psoriasis patients had a statistically significant higher risk of having subclinical atherosclerosis (OR 2.52, 95% CI: 1.23-5.16) than controls, after adjusting for traditional CVRF. Within psoriasis patients EAT volume was associated with subclinical atherosclerosis, independently of age, sex, psoriasis duration, classical CVRF and AVF.
Conclusion:
This study showed that psoriasis was associated with increased EAT volume independently of visceral abdominal fat and with subclinical atherosclerosis. Within psoriasis patients EAT volume was independently associated with CAC. EAT may be another important contributor to the higher cardiovascular risk observed in psoriasis.
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