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Coronary Microvascular Dysfunction in Asymptomatic Patients with Severe Psoriasis.
Stefano Piaserico1, Evangelia Papadavid2, Annagrazia Cecere3
1Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy.
The Journal of Investigative Dermatology
|September 22, 2023
Summary
Severe psoriasis patients often have coronary microvascular dysfunction (CMD), a condition linked to poor heart health. This study found CMD in 31.5% of psoriasis patients, highlighting the need for cardiovascular screening.
Area of Science:
- Cardiology
- Dermatology
- Immunology
Background:
- Severe psoriasis is linked to increased cardiovascular risk, potentially beyond traditional factors.
- Coronary microvascular dysfunction (CMD) predicts poor cardiovascular outcomes in general and psoriatic populations.
Purpose of the Study:
- To determine the prevalence and predictors of CMD in a large cohort of psoriasis patients without established cardiovascular disease.
Main Methods:
- 503 patients with psoriasis were enrolled.
- Transthoracic Doppler echocardiography was used to assess coronary microcirculation.
- 448 patients completed the study, with 31.5% diagnosed with CMD.
Main Results:
- CMD was present in 31.5% of the study cohort.
- Higher Psoriasis Area and Severity Index (PASI), longer disease duration, psoriatic arthritis, and hypertension were independently associated with CMD.
- Each 1-point PASI increase and each year of psoriasis duration correlated with a 5.8% and 4.6% increased CMD risk, respectively.
Conclusions:
- CMD is significantly associated with psoriasis severity and duration.
- Findings support a role for systemic inflammation in CMD, suggesting coronary microcirculation is an extracutaneous site of psoriatic immune-mediated injury.
- Active screening for CMD is recommended in severe psoriasis patients.
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