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Updated: Jul 12, 2026
Measuring Psoriasis Severity at Home
Published on: March 1, 2024
A practical inflammatory blood-cell marker for cardiovascular risk stratification in psoriasis: Development of the
Julian A Cortes1, Shaliz Aflatooni2, Andrea Ure3
1University of California, San Diego, School of Medicine, San Diego, California, United States of America.
Insights
The new Platelet-Leukocyte Adjusted Cardiovascular (PLAC) score effectively predicts atherosclerotic cardiovascular disease (ASCVD) risk in psoriasis patients. This psoriasis-specific tool integrates inflammatory markers for better cardiovascular monitoring.
Area of Science:
- Cardiology
- Dermatology
- Inflammation Research
Background:
- Psoriasis is linked to increased atherosclerotic cardiovascular disease (ASCVD) risk.
- Traditional ASCVD risk factors may not fully capture risk in psoriasis due to heightened inflammation.
Purpose of the Study:
- To develop and validate a psoriasis-specific ASCVD risk score.
- To integrate a novel inflammatory blood marker with established risk factors.
Main Methods:
- Retrospective cohort study of 1,572 psoriasis patients from the All of Us research program.
- Developed the Platelet-Leukocyte Adjusted Cardiovascular (PLAC) score using Cox regression.
- Included Neutrophil-to-Platelet-to-Monocyte Ratio (NuPMoR), age, sex, hypertension, and diabetes.
Main Results:
- The PLAC score demonstrated good discrimination (AUC 0.69) for ASCVD.
- Stratified patients into low (4.9%), medium (11.8%), and high (39.9%) 10-year ASCVD risk groups.
- High-risk groups showed significantly elevated ASCVD hazard compared to low-risk.
Conclusions:
- The PLAC score is a practical tool for ASCVD risk stratification in psoriasis.
- Integrates inflammatory markers with traditional factors for improved risk assessment.
- Facilitates identification of psoriasis patients needing closer cardiovascular surveillance.
Background:
Psoriasis is an inflammatory disease associated with atherosclerotic cardiovascular disease (ASCVD). Although blood-cell markers predict ASCVD in the general population, the utility of these markers in cardiovascular risk stratification in psoriasis remains unclear given heightened inflammatory burdens among these patients.
Objectives:
We aimed to develop a composite ASCVD risk score for psoriasis and evaluate its performance by integrating a novel inflammatory blood-cell marker with traditional cardiovascular risk factors.
Methods:
We conducted a retrospective cohort study using All of Us (enrollment:May 2018-October 2023). ASCVD included acute coronary syndrome, cerebrovascular accident, or coronary artery disease. Independent predictors of ASCVD in Cox regression informed the Platelet-Leukocyte Adjusted Cardiovascular (PLAC) score, incorporating the Neutrophil-to-Platelet-to-Monocyte Ratio (NuPMoR=neutrophils/[platelets x monocytes]), age ≥ 65, male sex, hypertension, and diabetes.
Results:
Among 1,572 psoriasis patients (median follow-up 7.2 years), the PLAC score (AUC 0.69, 95% CI 0.65-0.74), which incorporates NuPMoR, stratified patients into low-, medium-, and high-risk groups with corresponding 10-year ASCVD incidences of 4.9%, 11.8%, and 39.9%. Compared with the low-risk group, medium- (HR 2.27, 95% CI 1.53-3.39) and high-risk (HR 6.40, 95% CI 3.97-10.33) groups had significantly higher ASCVD hazard. The PLAC score demonstrated similar or numerically higher discrimination than the Framingham and PCE models in limited samples.
Conclusions:
The PLAC score is a practical, psoriasis-specific ASCVD risk tool that integrates a novel inflammatory marker with traditional risk factors. It enables clinically meaningful ASCVD risk stratification using routine laboratory values in a high-risk population and may help identify psoriasis patients warranting closer cardiovascular monitoring.
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