Abstract P405: Visceral Adipose Tissue Volume is Associated With Prevalent Coronary Plaque Independent of Total Adiposity in Psoriasis

Abstract

Introduction: Psoriasis (PSO) is a chronic inflammatory condition associated with accelerated atherosclerosis and increased risk of myocardial infarction in part mediated through high visceral adipose tissue (VAT) volume. VAT has been shown to be associated with increased coronary burden; however, the relationship with prevalent coronary plaque in PSO has not been explored. Hypothesis: We hypothesized that VAT would associate with coronary plaque in PSO beyond traditional risk factors. Methods: A total of 164 consecutive PSO patients underwent coronary computed tomography angiography (CCTA) as part of a large cohort study to assess presence of coronary plaque. Low-dose CT was utilized to quantify VAT and subcutaneous adipose tissue (SAT) volume from the level of the diaphragm to the pubic symphysis. Logistic regression was used to assess the association between the presence of coronary plaque and the ratio of VAT-to-total adiposity in adjusted models (STATA 12). Results: The cohort was middle-aged, predominantly male, relatively low CV risk by FRS and mild to moderate PSO (Table 1). Patients with increased VAT-to-total adiposity, had significantly increased coronary plaque presence (70% (45 of 65) vs. 31% (31 of 99), p<0.001) compared to those with low VAT-to-total adiposity. Moreover, increased VAT-to-total adiposity was associated with 3-fold higher odds of having a prevalent coronary plaque (adjusted OR 2.96 (1.22 - 7.22), p=0.016) after adjustment for Framingham risk score, body-mass-index, waist-to-hip ratio and lipid treatment. Conclusions: Having higher VAT was associated with higher prevalence of coronary plaque independent of total adiposity and cardiovascular risk factors. These findings suggest VAT contributes to coronary plaque in psoriasis and that weight loss efforts may improve outcomes in this high-risk population.