Cardiovascular risk profiles in a hospital-based population of patients with psoriatic arthritis and ankylosing spondylitis: a cross-sectional study

Abstract

The objective of the study was to investigate the frequency of traditional risk factors for the cardiovascular (CV) disease, to calculate the Systematic COronary Risk Evaluation (SCORE) for CV-related mortality in Danish patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS), and to compare with results from patients with rheumatoid arthritis (RA) from the same settlement. All PsA and AS patients aged 18-85 years from one outpatient clinic were invited. A rheumatology nurse conducted 30-min screening consultation, preceded by a lipid and glucose profile. High SCORE risk led to recommendation of follow-up by general practitioners. Multiple and logistic regression analyses, adjusted for age and gender, were performed, to compare risk factors and risk SCOREs. Participants were 116 AS (29.3% female) and 170 PsA (54.7% female). AS had opposed PsA patients' lower 10-year risk SCOREs of CV mortality than RA patients: AS versus RA coefficient -0.47 (confidence interval (CI) 95%: -0.84 to -0.) and PsA versus RA -0.14, (-0.43-0.16). Women with PsA and AS had increased waistline compared to women with RA [PsA vs. RA 7.94 (4.51-11.38); AS versus RA 6.67 (1.17-12.17)], and an increased prevalence of hypertension was seen in AS versus RA patients [1.87 (1.15-3.05)]. Traditional, modifiable CV risk factors were present in PsA and AS patients. AS but not PsA patients had an estimated lower 10-year risk of CV mortality than RA patients, according to the SCORE model adjusted for age and gender.

Registers of psoriatic arthritis. Literature review

“…Интересно, что обхват талии, тесно связанный с наличием превышения индекса массы тела (ИМТ), у женщин с ПсА превышает таковой у больных РА. А учитывая распространенность метаболических заболеваний среди больных ПсА, немаловажно подчеркнуть ассоциацию ожирения (ИМТ ≥30 кг/м 2 ) с более высокой активностью заболевания и уменьшением приверженности лечению и вероятности ответа на ингибиторы ФНОα в течение первых 6 мес терапии [63,64]. Немаловажными для рутинной клинической практики являются данные об отсутствии увеличения риска развития онкологических заболеваний при использовании ингибиторов ФНОα [65].…”

The relationship between obesity, cardiometabolic disorders and disease activity in psoriatic arthritis patients: data from the Russian register

“…У больных ПсА, страдающих ожирением, наблюдаются ассоциация с более высокой активностью заболевания, более низкая приверженность лечению и снижение вероятности ответа на ингибиторы фактора некроза опухоли α (ФНО-α) [12,13].…”

Cardiovascular disease in patients with psoriatic arthritis: correlation or causation?

“…The mean time to development of the fi rst CV risk factor during follow-up was 20.5 months for RA, 18.1 months for psoriasis, and the shortest -17.4 months for PsA [18]. PsA patients had a signifi cantly higher risk for obesity, high fasting glucose, and total and LDL-cholesterol levels, compared to those with RA [19]. The prevalence of depression, hyperlipidaemia, diabetes, history of ischaemic heart disease and other comorbidities have been estimated higher in PsA than RA participants in a large Australian cohort [20].…”

“…При проследяването средното време за развитие на първия сърдечно-съдов рисков фактор е 20.5 месеца за РА, 18.1 месеца за псориазис, а най-кратко -17.4 месеца -за ПсА [18]. При пациентите с ПсА е налице значително по-висок риск от затлъстяване, високи гликемии на гладно и повишен общ холестерол и холестерол с ниска плътност (LDL холестерол), в сравнение с тези с РА [19]. В голяма австралийска кохорта е установено, че честотата на депресията, хиперлипидемията, диабета, исхемичната болест на сърцето и други съпътстващи заболявания е по-голяма при ПсА в сравнение с РА [20].…”