Factors associated with high cardiovascular risk in psoriatic arthritis and non-psoriatic spondyloarthritis

Area of Science:

• Rheumatology and Cardiology
• Metabolic and Cardiovascular Health

Background:

• Psoriatic arthritis (PsA) and non-psoriatic spondyloarthritis (nPsA-SpA) share inflammatory pathways but differ in cardiovascular risk profiles.
• Understanding factors contributing to high cardiovascular risk (HCVR) in these conditions is crucial for targeted prevention.

Purpose of the Study:

• To investigate associations between traditional cardiovascular risk factors, disease-related factors, body composition, and adipokines with HCVR in PsA and nPsA-SpA.
• To identify predictors of HCVR in patients with spondyloarthritis.

Main Methods:

• A cross-sectional study compared age- and BMI-matched adults with PsA (n=56) and nPsA-SpA (n=58).
• Methods included dual-energy X-ray absorptiometry for body composition, adipokine measurement, disease characteristic assessment, QRISK3 cardiovascular risk scoring, and carotid intimal medial thickness (CIMT) measurement.
• HCVR was defined as QRISK3 ≥10% or CIMT ≥75th percentile.

Main Results:

• HCVR was present in 34.2% of patients.
• Sarcopenia (adjusted odds ratio [aOR] 15.83) and any traditional cardiovascular comorbidity (aOR 18.97) were significantly associated with HCVR.
• Patients with nPsA-SpA had a 97% lower chance of HCVR compared to PsA patients.
• Adipokine levels correlated with body composition but not HCVR.

Conclusions:

• Sarcopenia is a critical determinant of HCVR in spondyloarthritis, potentially linked to ectopic fat deposition in muscles.
• PsA is associated with a higher cardiovascular risk, necessitating further research into underlying mechanisms.
• Interventions focusing on preventing sarcopenia, managing cardiovascular risk factors, and controlling disease activity may mitigate atherosclerosis in SpA.