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Serum Urate as a Cardiometabolic Risk Enhancer Beyond SCORE2 in Psoriatic Arthritis
Lilyan C Charca1, Marta Loredo2, Estefanía Pardo2
1Rheumatology Section, Fundació Hospital de l'Esperit Sant, 08923 Santa Coloma de Gramenet, Spain.
Journal of Clinical Medicine
|August 13, 2026
Summary
Serum urate improves cardiovascular risk prediction in psoriatic arthritis patients beyond the standard SCORE2 assessment. This accessible marker helps identify subclinical atherosclerosis, enhancing risk stratification for better patient management.
Area of Science:
- Rheumatology
- Cardiology
- Biochemistry
Background:
- Cardiovascular risk (CVR) prediction models like SCORE2 may underestimate atherosclerosis in chronic inflammatory diseases.
- Subclinical atherosclerosis detection needs simpler markers for refined risk stratification.
Purpose of the Study:
- To assess if serum urate improves subclinical atherosclerosis detection in psoriatic arthritis (PsA) patients, beyond SCORE2.
- To evaluate serum urate's role in refining CVR stratification in PsA.
Main Methods:
- Cross-sectional study of 250 PsA patients (CASPAR criteria).
- Vascular assessment included ultrasound and radiography for atherosclerotic plaque.
- Multivariable logistic regression and decision curve analysis (DCA) were used.
Main Results:
- Hyperuricemia (21.6%) was linked to higher global plaque prevalence (88.9% vs. 62.8%).
- Serum urate independently predicted global plaque after SCORE2 adjustment (OR 4.23).
- Adding serum urate improved risk reclassification (cfNRI +0.60) in the 50-69 age group.
Conclusions:
- SCORE2 showed discordance with imaging-defined atherosclerosis in PsA patients.
- Serum urate is a valuable, accessible marker for refining CVR stratification.
- This marker can help identify PsA patients needing further vascular assessment.
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