The Number of Traditional Cardiovascular Risk Factors Is Independently Correlated with Disease Activity in Patients with Psoriatic Arthritis.

Iván Ferraz-Amaro,Alicia García-Dorta,Ricardo Blanco,Laura De Armas-Rillo,Susana Armesto,Miguel Á González-Gay,Belén Atienza-Mateo,David Martínez-López,Natalia Palmou-Fontana,Diana Prieto-Peña

doi:10.3390/medicina56080415

Abstract

Background and objectives: Psoriatic arthritis (PsA) is associated with several comorbidities, including among others an increased risk of cardiovascular (CV) disease, atherosclerosis, metabolic syndrome, hypertension dyslipidemia, and diabetes. The purpose of the present study was to determine how the number of CV risk factors correlates with disease related data such as disease activity. Materials and Methods: Cross-sectional study that encompassed 305 patients who fulfilled the CASPAR criteria for PsA were assessed for lipid profile, disease activity measurements, and the presence of six traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, chronic kidney disease, and smoking status). A multivariable regression analysis, adjusted for age, sex, and disease duration, was performed to evaluate if the number of classic CV risk factors was independently related with specific features of the disease, including disease activity. Results: Disease duration was found to be higher, after adjustment for age and sex, in patients with 1 or 2, and 3 or higher CV factors, compared to those patients without CV risk factors. Similarly, DAPSA (Disease Activity in PSoriatic Arthritis score) was found to be independently upregulated in patients with a higher number of CV risk factors. In this sense, as DAPSA score increases the odds ratio (OR) of having 1 or 2 (OR 1.12 (95% confidence interval (CI) 1.03–1.21), p = 0.010), and 3 or higher (OR 1.15 (95% CI 1.04–1.26), p = 0.004) CV factors was significantly higher compared to no CV risk factors category. This was independently found after adjustment for age, sex, and disease duration. Conclusions: PsA patients with a higher number of CV risk factors exhibit an upregulated disease activity compared to those without them. This is independent of disease duration and other demographics factors.

Highlights

IntroductionThe five leading modifiable risk factors (hypercholesterolemia, diabetes, hypertension, obesity, and smoking) are estimated to be responsible for more than half of cardiovascular (CV) mortality in the general population [1]
The five leading modifiable risk factors are estimated to be responsible for more than half of cardiovascular (CV) mortality in the general population [1]
The way in which CV risk factors correlate with disease related data in Psoriatic arthritis (PsA) has not been extensively explored. If this were the case, the inflammation would cause CV disease, but, in turn, the associated comorbidity would modify per se the inflammatory state in patients with PsA. Taking all this into account, we aimed to assess in this cross-sectional study whether patients with a higher number of CV risk factors may have a higher disease activity or if they express differential features related to the disease

Summary

Introduction

The five leading modifiable risk factors (hypercholesterolemia, diabetes, hypertension, obesity, and smoking) are estimated to be responsible for more than half of cardiovascular (CV) mortality in the general population [1]. Metabolic syndrome [8] and diabetes [9] are more common among patients with PsA than the general population and are associated with disease severity Most of these studies have the limitation that they are cross-sectional, these increased comorbidities have been attributed to the inflammatory burden that patients with PsA have [10]. Psoriatic arthritis (PsA) is associated with several comorbidities, including among others an increased risk of cardiovascular (CV) disease, atherosclerosis, metabolic syndrome, hypertension dyslipidemia, and diabetes. Materials and Methods: Cross-sectional study that encompassed 305 patients who fulfilled the CASPAR criteria for PsA were assessed for lipid profile, disease activity measurements, and the presence of six traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, chronic kidney disease, and smoking status).

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Conclusion