Polyarticular evolution and late‐onset psoriasis may be associated with cardiovascular disease in psoriatic arthritis

Abstract

Background and aims:Patients with psoriatic arthritis (PsA) have high prevalence of cardiovascular risk factors (CVRF), and they also show higher rates of cardiovascular disease (CVD). We aimed to corroborate these findings and identify factors associated with these events in our clinical setting. Methods:This cross-sectional study included 340 consecutive patients seen in a tertiary care hospital. The prevalence of CVRF was compared to that of 600 outpatients without inflammatory conditions. To analyze CVD-associated factors, odds ratio (OR) values were calculated by conditional logistic regression analysis. Significant variables in the univariate analysis were then introduced in a multivariate analysis with a backward stepwise approach.Results: Patients with psoriatic arthritis had higher frequencies of hypertension (36% vs 23%, OR 2.4, 95%CI: 1.6-2.7, P < 0.0001), diabetes (13.8% vs 5%, OR 2.8, 95%CI:1.7-4.3, P < 0.0001), obesity (35% vs 22%, OR 2.1, 95%CI: 1.5-2.8, P < 0.0001) and tobacco use (26% vs 21%, OR 1.4, 95%CI: 1.0-1.8, P < 0.05). More PsA patients had CVD compared to non-inflammatory patients (9.4% vs 5.8%, OR 1.68, 95%CI:1.02-2.76, P < 0.05). Independent CVD-associated factors were: an age of onset of psoriasis >40 years (OR 3.4, 95%CI: 1.1-10.0, P < 0.05), a high number of swollen joints during evolution (OR 2.9, 95%CI: 1.1-8.0, P < 0.05), hypertension (OR 5.3, 95%CI: 1.6-17.6, P < 0.01) and dyslipidemia (OR 2.6, 95%CI: 1.0-7.2, P < 0.05). Conclusions:Cardiovascular risk should be carefully evaluated in patients with PsA whose disease presents a high inflammatory burden and in those with late-onset psoriasis. K E Y W O R D S cardiovascular risk, polyarthritis, psoriasis, psoriatic arthritis, risk factors How to cite this article: Queiro R, Lorenzo A, Tejón P, Pardo E, Coto P, Ballina J. Polyarticular evolution and late-onset psoriasis may be associated with cardiovascular disease in psoriatic arthritis. Int J Rheum Dis. 2019;22:269-274. https://

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“…In another assessment of 2896 patients with PsA, AS or RA, obesity was more prevalent among those with PsA (23.0%) than in those with AS (17.0%) or RA (15.2%) ( 30 ). Similar results have been reported in two retrospective cross-sectional studies by Queiro and colleagues ( 31 , 32 ). One study showed that PsA patients had a significantly higher prevalence of obesity (35.0% vs 22.0%; p<0.0001), hypertension (36.0% vs 23.0%; p<0.0001) and diabetes (13.8% vs 5.0%; p<0.0001) compared with patients without inflammatory conditions ( 32 ).…”

Existe associação entre artrite psoriásica e obesidade em adultos?: uma revisão integrativa da literatura

“…A obesidade foi mais comum entre os pacientes com AP ou psoríase do que entre os pacientes sem apresentação inflamatória. Além do mais, a obesidade foi mais frequente entre os pacientes com psoríase sem artrite (QUEIRO et al, 2019). No entanto, Eder et al (2017) mostrou resultados diferentes ao observar que a obesidade estava mais associada a AP do que na psoríase sem artrite.…”

“…No entanto, Eder et al (2017) mostrou resultados diferentes ao observar que a obesidade estava mais associada a AP do que na psoríase sem artrite. Além da obesidade, os pacientes com AP apresentam outras comorbidades com frequência mais elevadas como hipertensão, diabetes e tabagismo (QUEIRO et al, 2019;KAINE et al, 2019).…”

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