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Cardiac and cardiovascular morbidities in patients with psoriatic arthritis: a population-based case control study
Adi Kibari1, Arnon D Cohen2,3, Tal Gazitt1
1Rheumatology Unit, Carmel Medical Center, 7 Michal Street, 34362, Haifa, Israel.
Insights
Psoriatic arthritis (PsA) patients exhibit a higher prevalence of cardiovascular disease (CVD) risk factors and related conditions. This highlights the critical need for increased clinical awareness and proactive management of CVD in PsA populations.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Background:
- Psoriatic arthritis (PsA) is a chronic inflammatory condition associated with increased cardiovascular disease (CVD) risk.
- Understanding the prevalence of CVD risk factors and morbidity in diverse PsA populations is crucial for effective management.
Purpose of the Study:
- To determine the prevalence of cardiovascular disease (CVD) risk factors and CVD-related morbidity within a large Middle Eastern cohort of psoriatic arthritis (PsA) patients.
- To compare the incidence of these conditions in PsA patients versus a matched control group.
Main Methods:
- A retrospective case-control study utilized a large Israeli healthcare database (2000-2013).
- PsA patients were matched with 10 controls without psoriasis or arthritis based on age and sex.
- Analysis included hypertension, hyperlipidemia, diabetes mellitus type 2, obesity, smoking, and various CVD morbidities, assessed via logistic regression.
Main Results:
- The study included 3,161 PsA patients (53.4% female, average age 58).
- PsA patients showed significantly higher prevalence of diabetes mellitus type 2, hyperlipidemia, hypertension, and obesity.
- Increased prevalence of ischemic heart disease, peripheral vascular disease, congestive heart failure, valvular heart disease, and cardiomyopathy was observed in the PsA group.
Conclusions:
- This Middle Eastern PsA cohort demonstrates a high prevalence of cardiovascular disease risk factors and morbidity, consistent with global findings.
- Clinicians must be vigilant regarding the elevated risk of CVD complications in patients with psoriatic arthritis.
- Proactive screening and management strategies for CVD are essential for this patient population.
Objective:
To assess the prevalence of risk factors associated with cardiovascular disease (CVD) and CVD-related morbidity in a large Middle-Eastern psoriatic arthritis (PsA) cohort.
Method:
A retrospective case control study was conducted using Israel's largest health care provider's patient database from 2000 to 2013. For each patient with PsA, 10 patients with no history of psoriasis or arthritis were matched for age and sex. Analysis of CVD-related risk factors and morbidity included hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus type 2 (DM-2), obesity, smoking, ischemic heart disease (IHD), congestive heart failure (CHF), cerebrovascular accident (CVA), carotid artery disease, peripheral vascular disease (PVD), aortic aneurism, valvular heart disease (VHD), and cardiomyopathy. Statistical analysis was conducted using t test and chi-square tests as appropriate. Univariate and multivariable logistic regression models assessed the association between PsA and CVD-related risk factors and morbidity.
Results:
Three thousand one hundred sixty-one PsA patients were included, with average age 58 ± 15.0 years, of whom 53.4% were women. Increased prevalence of DM-2, HLD, HTN, and obesity (OR 1.7, 1.5, 1.5, 1.5 respectively) was noted in the PsA group. Increased prevalence of IHD (p < 0.0001), PVD (p < 0.0001), CHF (p = 0.002), VHD (p < 0.0001), and cardiomyopathy (p = 0.006) was found in the PsA group compared to the control group even after adjusting for CVD risk factors.
Conclusions:
A high prevalence of CVD-related risk factors and morbidity was found in this Middle Eastern PsA population, in accordance with data from other geographic regions. These results emphasize the importance of clinician awareness of the increased risk for CVD-related complications in PsA patients.
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