POS1086 HIGH CARDIOVASCULAR RISK IN PATIENTS WITH PSORIATIC ARTHRITIS: EVALUATION OF MACROANGIOPATHY AND ITS PREDICTORS BY AORTIC PULSE WAVE VELOCITY.

Abstract

BackgroundSystemic inflammatory rheumatic diseases are associated with macroangiopathy and increased cardiovascular (CV) risk [1, 2]. Psoriatic arthritis (PsA) has also been associated with an increased risk of CV events. However, data on diagnostic CV markers in PsA are scarce. Carotid-femoral pulse wave velocity (cfPWV; oscillometric diagnostic method) is considered to be the gold standard evaluation method of aortic stiffness and is used in the general population to assess CV risk (Figure 1). Moreover, EULAR and the European Society of Cardiology (ESC) recommend the use of Systematic Coronary Risk Evaluation (ESC-SCORE) in order to screen and classify patients regarding CV risk.Figure 1.Measurement of aortal pulse wave velocity: pulse waves of carotid and femoral artery (Δt: time, L: distance between the two arteries, m/s: meters/second), modified after [3].ObjectivesAim of this study was to evaluate aortic stiffness and CV risk in patients with PsA based on measurements of cfPWV and ESC-SCORE. Moreover, we sought to investigate associations of cfPWV with patient- and disease-associated characteristics, as well as with traditional CV risk factors.MethodscfPWV measurements were performed in patients with PsA from two large rheumatological medical departments in Germany, according to the classification criteria for psoriatic arthritis (CASPAR), and in healthy control subjects. In addition to assessing cfPWV, clinical and laboratory parameters were evaluated, traditional CV risk factors were documented, and the ESC-SCORE was determined. Differences in cfPWV measurements between the two groups and associations between cfPWV and patient- or disease-associated characteristics were examined statistically (correlation analyses, Mann-Whitney-U-Tests, ANOVA and multivariate regression analyses).Results112 patients with PsA [55.45%♀, median age: 55 years, IQR 47-63] and 88 healthy control subjects [81%♀, median age: 51 years, IQR 36.5-58] were recruited. cfPWV was significantly higher in PsA patients compared to the healthy control subjects (p < 0.001), even after the adjustment for the effect of confounding factors. In both the patient and the control group, cfPWV correlated with age (r =0.560, p <0.01 and r =0.638, p <0.01, respectively). In addition, cfPWV showed a moderate significant correlation with the ESC-SCORE (r =0.280, p =0.22) and a weak significant association with mean arterial pressure (rho =0.19, p =0.043) in the patient group. No statistical associations could be found between cfPWV and lipid levels, CRP levels or DAS28 (all; p>0.05). Moreover, no significant differences regarding cfPWV measurements could be observed between patients with and without active disease.ConclusionThis is one of the largest CV surrogate marker studies in patients with PsA. We were able to show that PsA patients had significantly higher aortic stiffness values, and thus, a higher CV risk compared to healthy individuals. Therefore, cfPWV could be a useful tool for the identification of PsA patients at high-risk. The fact that aortic stiffness can be predicted by mean arterial pressure and ESC-SCORE could assist forming therapeutic strategies that would promote artery de-stiffening and thus CV risk lowering.