Abstract
It is known that both psoriasis (PSO) limited to the skin and psoriatic arthritis (PSA) increase the risk of cardiovascular complications and atherosclerosis progression by inducing systemic inflammatory response. In recent decades, the introduction of biological medications directed initially against TNF-α and, later, different targets in the inflammatory cascade brought a significant breakthrough in the efficacy of PSO/PSA treatment. In this review, we present and discuss the most recent findings related to the interplay between the genetics and immunology mechanisms involved in PSO and PSA, atherosclerosis and the development of cardiac dysfunction, as well as the current PSO/PSA treatment in view of cardiovascular safety and prognosis.
Highlights
Both psoriasis (PSO) and psoriatic arthritis (PSA) are connected to chronic systemic inflammation which plays a key role in the development of atherosclerosis (Ath) and its cardiovascular complications resulting in myocardial infarctions and strokes
The PubMed database was searched for publications in English until August 2021 with the usage of MesH search terms: psoriasis and psoriatic arthritis, in combination with cardiovascular disease, atherosclerosis and each of the standard and new treatments described in the article
Disease/State Related to Psoriasis Psoriatic arthritis (PSA) Metabolic syndrome Nonalcoholic fatty liver disease Inflammatory bowel disease (IBD): Crohn’s disease and ulcerative colitis
Summary
Both psoriasis (PSO) and psoriatic arthritis (PSA) are connected to chronic systemic inflammation which plays a key role in the development of atherosclerosis (Ath) and its cardiovascular complications resulting in myocardial infarctions and strokes. The doubled risk of major adverse cardiovascular events (MACE) was described for the first time in 1973 in PSO patients who were compared to patients with other dermatological disorders [8] This was further confirmed by meta-analysis including 14 cohort studies identifying increased CVD (cardiovascular disease) risk in patients with severe PSO, defined as requiring systemic therapy or hospitalization [9]. Disease/State Related to Psoriasis Psoriatic arthritis (PSA) Metabolic syndrome Nonalcoholic fatty liver disease Inflammatory bowel disease (IBD): Crohn’s disease and ulcerative colitis This form of psoriasis (PSO) involving joints is related to higher prevalence of cardiovascular and metabolic risk factors, atherosclerosis progression, as well as cardiovascular complications including myocardial infarction and strokes as compared to psoriasis limited only to the skin [30,31,32,33]. Observed reciprocal association between decreased probability of performing more intense physical activity when suffering from PSO, as well as reduced risk of PSO incidence in those performing vigorous physical activity [83,84]
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