Guilty by Association: Platelet Reactivity and Inflammation in Psoriatic Arthritis

Abstract

Patients with rheumatoid arthritis (RA) die prematurely from cardiovascular disease (CVD)1. The risk of adverse cardiovascular events and subsequent mortality in patients with RA is comparable to that associated with type 2 diabetes mellitus2. There is an emerging body of evidence that patients with other forms of inflammatory arthritis (IA), in particular psoriatic arthritis (PsA), are at a similarly elevated risk of CVD3. Platelets play a key role in the complex chain of events leading to the thrombotic occlusion of a coronary artery4. Antiplatelet therapy with aspirin and/or a variety of other agents is effective at reducing the mortality associated with incident CVD5 and is recommended for the primary prevention of same in patients at high risk of atherothrombotic events4. Despite the greatly increased risk of heart disease and strokes, there are currently no antiplatelet guidelines for the primary prevention of CVD in patients with IA3, and platelet function remains largely uninvestigated in this patient population. It is within this context that the recent work of Di Minno and colleagues, reported in this issue … Address correspondence to Dr. MacMullan; E-mail: pmacmullan{at}hotmail.com