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Disease Activity and Increased Risk of Cardiovascular Death among Patients with Psoriatic Arthritis

Kristina Juneblad1,2, Solbritt Rantapää-Dahlqvist3,4, Gerd-Marie Alenius3,4

  • 1From the Department of Public Health and Clinical Medicine, and the Department of Rheumatology, University Hospital, Umeå, Sweden. kristina.juneblad@vll.se.

The Journal of Rheumatology
|December 3, 2016
PubMed

Insights

Patients with psoriatic arthritis (PsA) have a slightly increased risk of death from circulatory diseases. Higher disease activity and combined axial and peripheral involvement are linked to increased mortality in PsA patients.

Area of Science:

  • Rheumatology
  • Cardiology
  • Epidemiology

Background:

  • Psoriatic arthritis (PsA) is associated with increased cardiovascular (CV) morbidity and mortality, though findings are inconsistent.
  • Understanding the specific mortality rates and causes of death in PsA patients is crucial for risk stratification and management.

Purpose of the Study:

  • To investigate the mortality rate, causes of death, and incidence of acute CV events in a cohort of PsA patients from northern Sweden.
  • To determine the association between disease activity and mortality in PsA.

Main Methods:

  • A cohort of 464 patients with established PsA was studied from 1995-2011.
  • Standardized mortality ratios (SMR) and standardized incidence ratios (SIR) for CV events were calculated by comparing PsA patients to the general population using Swedish national registers.
  • Disease activity index (DAI) and disease phenotype (peripheral vs. axial and peripheral) were analyzed for their association with mortality.

Main Results:

  • The SMR for death from circulatory diseases (ICD-10: I00-I99) was 1.64 (95% CI 1.02-2.52), indicating a significant increase compared to the general population.
  • Higher DAI was significantly associated with death (OR 1.99), as was the combination of axial and peripheral disease (OR 4.02).
  • The SIR for CV events (myocardial infarction or stroke) was 0.597, a significant decrease, but this was only observed in men.

Conclusions:

  • PsA patients exhibit a small but significant increase in mortality due to circulatory system diseases.
  • Disease activity and more aggressive disease phenotypes (axial and peripheral involvement) are associated with increased mortality in PsA patients.
  • The observed lower incidence of CV events in PsA patients warrants further investigation, particularly regarding sex differences.
Abstract

Keywords:
CARDIOVASCULAR DISEASESDISEASE ACTIVITYEPIDEMIOLOGYMORTALITYPSORIATIC ARTHRITIS

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