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Prevalence and severity of coronary artery disease linked to prognosis in psoriasis and psoriatic arthritis patients: a multi‐centre cohort study
Ist Teil von
Journal of internal medicine, 2021-09, Vol.290 (3), p.693-703
Ort / Verlag
England: Blackwell Publishing Ltd
Erscheinungsjahr
2021
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
Objectives
(i) To estimate the prevalence and severity of coronary artery disease and (ii) to assess the risk of cardiovascular events and mortality, in patients with psoriasis and psoriatic arthritis (PsA) in a large‐scale cohort of patients referred to coronary computed tomography angiography (CTA).
Methods
This was a cross‐sectional study with follow‐up of 46,022 patients based on data from a Danish national CTA registry. Exposure was defined as psoriasis or PsA. A group of patients without psoriasis, PsA or any other inflammatory disease was used as reference. Cross‐sectional primary outcomes were a coronary artery calcium score (CACS) >0 and CACS ≥400, and secondary outcome was obstructive CAD. At follow‐up, the primary outcome was a composite endpoint of cardiovascular events and all‐cause mortality. All outcomes were adjusted for traditional cardiovascular risk factors.
Results
We identified 1356 psoriasis and 370 PsA patients. The adjusted odds ratio (OR) for psoriasis patients for CACS >0, CACS ≥400 and obstructive CAD was 1.26 (1.10–1.46), 1.25 (1.04–1.50) and 1.14 (0.98–1.33), respectively. For PsA patients, OR for CACS >0 was 1.28 (1.00–1.64). We found a crude hazard ratio (HR) of 1.49 (1.21–1.85) and adjusted HR of 1.14 (0.92–1.41) for the primary outcome in psoriasis patients.
Conclusions
In this population, both psoriasis and PsA were associated with an increased prevalence of coronary calcification. Psoriasis patients also showed an increased prevalence of severe calcification. Psoriasis patients were at increased risk for cardiovascular events and death, however not after adjusting for the effect of other predictors.