279 Electrocardiogram abnormalities in Filipino patients with psoriasis in a tertiary hospital

Abstract

Systemic chronic inflammation, endothelial dysfunction, and increased oxidative stress are the mechanisms in the development of psoriasis. Increasing evidence points to the possible association between psoriasis and cardiac diseases, which can initially manifest as electrocardiogram (ECG) abnormalities. This paper aims to identify the common ECG abnormalities seen in psoriasis patients and to determine its association with psoriasis severity. This is a prospective, cross-sectional study among psoriasis patients. Demographic data, clinical data, and psoriasis profile were collected and 12L-ECG recordings were obtained. Independent t-test and ANOVA were used for continuous variables while chi-square test was used for categorical variables. Logistic regression was used to determine the association of ECG abnormalities with the severity of psoriasis. Out of a total of 115 patients, 35% have abnormal ECG findings. ST-wave changes and conduction abnormalities were the most commonly detected. The abnormal ECG group had significantly older age, higher systolic blood pressure, longer disease duration, higher incidence of hypertension and diabetes, more frequent use of methotrexate and more severe psoriasis, compared to the normal ECG group. Logistic regression analysis showed that patients with severe psoriasis are about 2.5 times (OR 2.50; 1.14 5.51, p=0.02) more likely to present with ECG abnormalities. However, after adjusting the confounding effects of methotrexate use and diabetes, both mild and severe psoriasis have a similar risk of developing ECG abnormalities. Abnormal ECG findings, particularly ST-wave changes and conduction abnormalities, are commonly seen in psoriasis patients. These ECG findings may be an independent and early marker of coronary disease. Age, hypertension, diabetes, use of methotrexate, long disease duration and severity of psoriasis are also significant factors associated with ECG abnormalities. Moreover, methotrexate use and diabetes may directly increase the risk of ECG abnormalities, regardless of psoriasis severity.