Psoriatic Arthritis Features and Risk of Cardiovascular Events: A Nationwide Cohort Study

Area of Science:

• Rheumatology
• Cardiology
• Epidemiology

Background:

• Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with an increased risk of cardiovascular (CV) events.
• Specific clinical manifestations of PsA may influence this CV risk, but evidence is limited.

Purpose of the Study:

• To evaluate whether specific clinical features of psoriatic arthritis, including dactylitis and enthesitis, serve as predictors of incident cardiovascular events.
• To investigate the association between joint counts, nail involvement, and psoriasis severity with cardiovascular risk in PsA patients.

Main Methods:

• Analysis of data from 3,696 PsA patients without prior CV events from the CorEvitas US registry.
• Tracking participants for a mean of 3.69 years to identify CV events.
• Utilizing Cox regression models to assess hazard ratios for CV events based on dactylitis, enthesitis, joint counts, nail involvement, and body surface area psoriasis.

Main Results:

• No statistically significant association was observed between dactylitis, enthesitis, or other assessed clinical features and the development of cardiovascular events.
• Dactylitis and enthesitis were found to be highly prevalent in each other's presence, and both were associated with increased tender and swollen joint counts.
• These findings contrast with previous studies suggesting a link between these PsA features and CV risk.

Conclusions:

• The specific clinical features of psoriatic arthritis, including dactylitis and enthesitis, did not emerge as significant predictors of cardiovascular risk in this observational study.
• The high co-occurrence of dactylitis and enthesitis highlights their interconnectedness in PsA.
• Further investigation is warranted to elucidate the complex relationship between psoriatic arthritis and cardiovascular disease, potentially exploring different risk factors or patient subgroups.