Performance of Coronary Artery Calcium Testing in Patients With Severe Psoriasis: Risk Assessment and...

Area of Science:

• Cardiology
• Dermatology
• Radiology

Background:

• Patients with severe psoriasis exhibit elevated cardiovascular (CV) risk and subclinical coronary artery disease (CAD).
• Coronary artery calcium (CAC) testing offers improved CV risk assessment beyond traditional clinical scores.

Purpose of the Study:

• To evaluate subclinical CAD presence and magnitude via CAC scoring in severe psoriasis patients across different CV risk categories.
• To assess the potential for CV risk reclassification using CAC scores in this population, originating from a low CV risk background.

Main Methods:

• A cross-sectional study involving 111 severe chronic plaque psoriasis patients from a low CV risk Mediterranean population.
• Patients were stratified into four CV risk categories per ESC/EAS guidelines.
• Coronary computed tomography was used to determine CAC scores, with specific criteria for risk reclassification.

Main Results:

• Subclinical CAD was detected in 41.4% of patients.
• Among non-high-risk categories, 25.6% had subclinical CAD, with 17.1% eligible for risk reclassification.
• Age was the sole predictor for both subclinical CAD presence and risk reclassification.

Conclusions:

• Over 40% of severe psoriasis patients from low-risk regions possess subclinical CAD, with up to 25% in non-high-risk groups.
• CAC testing is valuable for refining CV risk assessment in severe psoriasis patients.
• Further investigation is needed to integrate CAC testing into routine dermatology practice for severe psoriasis management.