SUN-545 High Prevalence of Cardiometabolic Diseases and Abdominal Aortic Calcification in Psoriasis

Abstract

Psoriasis has been shown to increase the risk of cardiovascular disease. Studies indicate that the presence of abdominal aortic calcification (AAC) is a strong predictor of future cardiovascular events and all-cause mortality. Multi-detector computed tomography provides a reliable and accurate method for the detection of abdominal aortic calcification. The aim of this study was to investigate the prevalence of AAC in patients with psoriasis. Adult psoriasis patients (n=69) and controls (n=80) were recruited from the Dermatology and Rheumatology clinics at 3 academic hospitals in Johannesburg, South Africa. Controls were matched for gender, ethnicity and body mass index (BMI). Non-contrast abdominal CT imaging was performed on patients and controls. The images were then assessed for presence and location (supra-coeliac, supramesenteric, supra-renal, proximal infra-renal, aortic bifurcation) of AAC. Patients had a mean age and disease duration of 53.3 ± 14.5 years and 18.9 ± 13.3 years, respectively. There was a significantly higher prevalence of smoking, hypertension and type 2 diabetes in patients compared to controls (56.5% vs 25.0%, P<0.005; 72.5% vs 55.0%, P<0.005; 24.6% vs 3.80%, P<0.0005, respectively). Furthermore, there was a significantly higher prevalence of AAC at any site in psoriasis patients (47.8% vs 22.5%, P<0.005). The aortic bifurcation was the commonest site for AAC in patients and controls, and the prevalence was significantly higher in the psoriasis group (42.0% vs 21.3%, p<0.005). However, multivariable logistic regression analysis demonstrated that age, smoking and the metabolic syndrome were significantly associated with AAC (P<0.0001, P=0.0002, P=0.027 respectively) and attenuated the relationship between psoriasis and AAC to non-significance (P=0.376). This suggests the increased risk of aortic calcification in psoriasis is mediated by the high prevalence of cardiometabolic disease in this population. These data highlight the increased cardiovascular disease risk within subjects with psoriasis and the need for lifestyle modification to decrease risk factor burden.