Epicardial adipose tissue and coronary artery calcification in psoriasis patients

Torres, Tiago; Bettencourt, Nuno; Mendonça, Denisa; Vasconcelos, Carlos; Gama, Vasco; Silva, Ana Martins; Selores, Manuela

doi:10.1111/jdv.12516

Cited by 41 publications

(41 citation statements)

References 46 publications

(83 reference statements)

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“…Indeed, a recent hospital‐based survey revealed that psoriasis vulgaris is associated with the incidence of coronary heart diseases in Japanese . Our observation is also consistent with previous reports that the relative risks of CVD in severe psoriatic patients are greatest in younger individuals …”

Section: Discussionsupporting

confidence: 92%

“…Epicardial adipose tissue functions as a paracrine organ by releasing bioactive adipocytokines into the adjacent interstitium of the myocardium and coronary arteries, and may represent cardiovascular risk . Recent studies have shown significantly higher EAT volume in psoriatic patients compared with control subjects, and EAT was independently associated with the presence of CAC . There is a correlation between EAT and BMI or metabolic syndrome, but Japanese psoriatic patients comprise only 0.34% of the population, with metabolic syndrome and obesity generally much less prevalent than Caucasians .…”

Section: Discussionmentioning

confidence: 99%

“…Psoriatic patients are known to have a high prevalence of dyslipidemia, diabetes, hypertension and metabolic syndrome. These comorbidities overlap with risk factors of cardiovascular diseases (CVD), and psoriasis may predispose to subclinical atherosclerosis …”

Section: Introductionmentioning

confidence: 99%

“…EAT is known to secrete inflammatory adipocytokines, and by encasing coronary arteries, EAT may lead to the development of CVD . In this study, we aimed to validate whether EAT volume may be associated with psoriasis in a Japanese population, together with coronary artery calcification (CAC) as a marker of subclinical atherosclerosis …”

Section: Introductionmentioning

confidence: 99%

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Evaluation of epicardial adipose tissue volume and coronary artery calcification in Japanese patients with psoriasis vulgaris

Momose

Asahina

Fukuda

et al. 2018

The Journal of Dermatology

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Epicardial adipose tissue (EAT) is implicated in the development of coronary atherosclerosis by secretion of inflammatory adipocytokines. Recent studies have shown significantly higher EAT volume in psoriatic patients compared with that in control subjects, but this has not been validated in Japanese patients. We enrolled 86 Japanese patients with moderate to severe psoriasis vulgaris and 31 control subjects, and evaluated EAT volume and coronary artery calcification (CAC) by retrospectively assessing non-enhanced computed tomography obtained through routine examinations. Both mean EAT volume and mean CAC score were not significantly different between the two groups. Interestingly, however, a subanalysis with those of 50 years of age or less (28 psoriatic patients and seven non-psoriatic subjects) showed significantly higher mean EAT volume in psoriatic patients. Similarly, the ratio of the presence of at least one CAC was significantly higher in this group. Our findings suggest that Japanese psoriatic patients should also be aware of the cardiovascular risk, and EAT volume and CAC may be useful tools to predict such risk.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of epicardial adipose tissue volume and coronary artery calcification in Japanese patients with psoriasis vulgaris

Momose

Asahina

Fukuda

et al. 2018

The Journal of Dermatology

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“…Increased epicardial adipose tissue (EAT) has been associated with autoimmune disorders, such as psoriasis (5) and rheumatoid arthritis (6), and with cardiometabolic diseases such as type 2 diabetes mellitus (7), coronary artery disease (CAD) (8–11), and atrial fibrillation (12,13). It is postulated that close proximity of the increased EAT to the heart and vessels (14) and the lack of a physical barrier between these structures allow for diffusion of proinflammatory cytokines that could play role in the development of cardiometabolic diseases (14–16).…”

Section: Introductionmentioning

confidence: 99%

Increased Epicardial Fat Volume Is Independently Associated with the Presence and Severity of Systemic Sclerosis

Long

Stojanovska²,

Brown

et al. 2017

Academic Radiology

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Rationale and Objectives The study aimed to determine if intrathoracic fat volumes are associated with the presence and severity of systemic sclerosis (SSc), defined by the presence of pulmonary arterial hypertension (PAH). Materials and Methods A total of 265 patients were included in the study, 202 of whom had SSc (134 had SSc with no PAH and 68 had SSc-associated PAH) and who underwent high-resolution computed tomography, and 63 controls who underwent coronary computed tomography angiography with calcium scoring. Intrathoracic and epicardial (EFV) fat volumes were quantified by manual tracing of the mediastinum and the pericardium, the difference of which represents the extrapericardial fat volume. Associations between these three fat volumes and the presence and severity of SSc, adjusted for cardiovascular risk factors and interstitial lung disease, were evaluated by logistic regression analysis. Results Of the 202 patients with SSc, the mean age was 54 years (ranged from 20 to 86), and 79% (192 of 202) were women. Adjusted EFV (odds ratio [OR]: 1.065; 95% confidence interval [CI]: 1.046–1.084, P = < 0.0001), ≤extrapericardial fat volume (OR: 1.028, 95% CI: 1.017–1.038, P = < 0.0001), and intrathoracic fat volume (OR: 1.033, 95% CI: 1.023–1.043, P = 0.001) were associated with the presence of SSc. Only EFV was associated with SSc severity (adjusted OR: 1.010, 95% CI: 1.003–1.018, P = 0.007). Conclusion Increased epicardial fat volume is associated with the presence and severity of SSc, independent of cardiovascular risk factors and interstitial lung disease.

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Comparison of Coronary Artery Calcium Scores Between Patients With Psoriasis and Type 2 Diabetes

et al. 2016

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IMPORTANCEPsoriasis is associated with an increased risk of cardiovascular diseases. Subclinical atherosclerosis in patients with psoriasis has not been compared with other conditions associated with increased cardiovascular risk and more rigorous cardiovascular disease screening, such as type 2 diabetes. OBJECTIVE To assess the burden of asymptomatic coronary atherosclerosis measured by coronary artery calcium score in patients with moderate to severe psoriasis compared with patients with type 2 diabetes and healthy controls.DESIGN, SETTING, AND PARTICIPANTS Three single-center, cross-sectional studies were performed in patients recruited from specialty outpatient clinics with moderate to severe psoriasis without type 2 diabetes (recruited from November 1, 2013, through April 31, 2015), patients with type 2 diabetes without psoriasis or other inflammatory diseases (recruited from July 1, 2009, through June 20, 2011), and age-and sex-matched healthy controls without psoriasis, type 2 diabetes, or other inflammatory diseases (recruited from July 1, 2009, through June 20, 2011).EXPOSURES Psoriasis, type 2 diabetes, and healthy control effect on coronary artery calcium score. MAIN OUTCOMES AND MEASURES Coronary artery calcium measured by Agatston score.RESULTS A total of 387 individuals participated in the study. Mean (SD) age was 51 (7.7), 52 (8.0), and 52 (8.0) years in the psoriasis, type 2 diabetes, and healthy control cohorts, respectively. There were 64 men (49.6%) in each group, and most patients were white (119 [92.2%], 123 [95.3%], and 128 [99.2%] in the psoriasis, type 2 diabetes, and healthy control cohorts, respectively). Patients with psoriasis had low cardiovascular risk measured by the Framingham Risk Score but had a high prevalence of cardiovascular and cardiometabolic risk factors, similar to patients with type 2 diabetes. In a fully adjusted model, psoriasis was associated with coronary artery calcium (Tobit regression ratio, 0.89; P < .001) similar to the association in type 2 diabetes (Tobit regression ratio, 0.79; P = .04). Likelihood ratio testing revealed incremental value for psoriasis in a fully adjusted model (χ 2 = 4.48, P = .03) in predicting coronary artery calcium. Psoriasis was independently associated with the presence of any coronary artery calcium (odds ratio, 2.35; 95% CI, 1.12-4.94) in fully adjusted models, whereas the association of coronary artery calcium with type 2 diabetes was no longer significant after adding body mass index to the model (odds ratio, 2.18; 95% CI, 0.75-6.35).CONCLUSIONS AND RELEVANCE Patients with psoriasis have increased coronary artery calcium by mean total Agatston scores, similar to that of patients with type 2 diabetes, suggesting that patients with psoriasis harbor high rates of subclinical atherosclerosis beyond adjustment for body mass index. Major educational efforts for patients and physicians should be undertaken to reduce the burden of cardiovascular disease in patients with psoriasis.

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Epicardial adipose tissue and coronary artery calcification in psoriasis patients

Cited by 41 publications

References 46 publications

Evaluation of epicardial adipose tissue volume and coronary artery calcification in Japanese patients with psoriasis vulgaris

Evaluation of epicardial adipose tissue volume and coronary artery calcification in Japanese patients with psoriasis vulgaris

Increased Epicardial Fat Volume Is Independently Associated with the Presence and Severity of Systemic Sclerosis

Comparison of Coronary Artery Calcium Scores Between Patients With Psoriasis and Type 2 Diabetes

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