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Cardiovascular risk markers in patients with psoriatic arthritis: A meta-analysis of literature studies
Matteo Nicola Dario Di Minno1, Pasquale Ambrosino, Roberta Lupoli
1Unit of Cell and Molecular Biology in Cardiovascular Diseases, Centro Cardiologico Monzino , IRCCS, Milan , Italy.
Insights
Psoriatic arthritis (PsA) patients exhibit increased cardiovascular risk, evidenced by higher carotid artery intima-media thickness and plaque prevalence. PsA is significantly linked to subclinical atherosclerosis markers, necessitating targeted CV prevention strategies.
Area of Science:
- Rheumatology
- Cardiology
- Vascular Biology
Background:
- Psoriatic arthritis (PsA) is associated with increased cardiovascular (CV) morbidity and mortality.
- Existing research indicates a need for a comprehensive analysis of CV risk markers in PsA patients.
Purpose of the Study:
- To conduct a meta-analysis evaluating the impact of PsA on key CV risk markers.
- To synthesize evidence on subclinical atherosclerosis in PsA patients.
Main Methods:
- Systematic literature search of PubMed, Web of Science, Scopus, and EMBASE databases.
- Inclusion of 16 case-control studies (898 PsA cases, 1,140 controls).
- Meta-analysis of common carotid artery intima-media thickness (CCA-IMT), carotid plaque prevalence, and flow-mediated dilation (FMD).
Main Results:
- PsA patients demonstrated significantly higher CCA-IMT (MD 0.07 mm) and carotid plaque frequency (OR 3.12) compared to controls.
- A significant reduction in FMD was observed in PsA patients (MD -2.56%).
- No significant difference in nitrate-mediated dilation (NMD) was found; data for PWV, AIx, and ABI were insufficient for meta-analysis.
Conclusions:
- PsA is significantly associated with markers of subclinical atherosclerosis and increased CV risk.
- Findings support the need for tailored CV prevention strategies in PsA management.
Introduction:
Several studies reported an increased cardiovascular (CV) morbidity and mortality in patients with psoriatic arthritis (PsA). We performed a meta-analysis on the impact of PsA on major markers of CV risk.
Methods:
Studies on the relationship between PsA and common carotid artery intima-media thickness (CCA-IMT), prevalence of carotid plaques, flow-mediated dilation (FMD), nitrate-mediated dilation (NMD), pulse wave velocity (PWV), augmentation index (AIx), and ankle-brachial index (ABI) were systematically searched in the PubMed, Web of Science, Scopus, and EMBASE databases.
Results:
Sixteen case-control studies (898 cases, 1,140 controls) were included. Compared to controls, PsA patients showed a higher CCA-IMT (MD 0.07 mm; 95% CI 0.04, 0.11; P < 0.0001), and a higher frequency of carotid plaques (OR 3.12; 95% CI 1.03, 9.39; P = 0.04). Moreover, a lower FMD was found in PsA subjects than in controls (MD -2.56%; 95% CI -4.17, -0.94; P = 0.002), with no differences in NMD (MD -0.40%; 95% CI -1.19, 0.39; P = 0.32). Because of the low number of studies, no meta- analytical evaluation was performed for PWV, AIx, and ABI. Despite heterogeneity among studies, PsA appears significantly associated with markers of subclinical atherosclerosis and CV risk.
Discussion:
These findings could help to establish more specific CV prevention strategies in this clinical setting.
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