The impact of psoriasis on 10-year Framingham risk

Mehta, Nehal N.; Krishnamoorthy, Parasuram; Yu, YiDing; Khan, Omar; Raper, Anna; Voorhees, Abby Van; Troxel, Andrea B.; Gelfand, Joel M.

doi:10.1016/j.jaad.2012.05.016

Cited by 51 publications

(52 citation statements)

References 5 publications

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“…However, since clinical risk prediction algorithms, such as the Framingham risk score, do not factor in the effect of systemic inflammation secondary to psoriatic disease in the risk assessment, they may underestimate the actual risk 31 32. Similar findings were reported in RA 33.…”

Section: Discussionsupporting

confidence: 55%

Incidence and predictors for cardiovascular events in patients with psoriatic arthritis

Eder

Chandran

et al. 2015

Ann Rheum Dis

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Section: Discussionsupporting

confidence: 55%

Incidence and predictors for cardiovascular events in patients with psoriatic arthritis

Eder

Chandran

et al. 2015

Ann Rheum Dis

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“…Importantly, in a study to determine the impact of psoriasis on the Framingham Risk Score (FRS), adding psoriasis to the FRS resulted in reclassification of a majority of patients to a higher CV risk category whereby 73% of patients at low risk were reclassified as intermediate risk and 53% of patients at intermediate risk as high risk. 31 Putting the psoriasis-associated CV risk into context with other chronic inflammatory diseases, Ahlehoff, et al 30 found the increased risk of MACE associated with severe psoriasis to be nearly identical to that conferred by diabetes alone. Similarly, a single observational study of patients with rheumatoid arthritis (RA) and psoriasis suggests that patients treated with similar systemic treatments (e.g., methotrexate) each have similarly elevated risks of MACE, independent of traditional risk factors.…”

Section: Cardiometabolic Diseasementioning

confidence: 99%

Psoriasis and comorbid diseases

Takeshita

Grewal

Langan

et al. 2017

Journal of the American Academy of Dermatology

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830

703

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Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic disease, gastrointestinal disease, kidney disease, malignancies, infections, and mood disorders. The pathogenesis of comorbid disease in psoriasis patients remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of healthcare providers is essential to ensuring comprehensive medical care for patients with psoriasis.

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“…Traditional risk assessment does not accurately capture the increased CV risk among psoriasis patients 26 , and many patients with CVD and related events in psoriasis are young 23, 25 with low Framingham risk scores 26 . As such, psoriasis provides a reliable human model to study the utility of novel inflammatory biomarkers for predicting subclinical CVD in chronic inflammatory states.…”

Section: Introductionmentioning

confidence: 99%

GlycA Is a Novel Biomarker of Inflammation and Subclinical Cardiovascular Disease in Psoriasis

Joshi

Lerman

Aberra

et al. 2016

Circulation Research

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Rationale GlycA, an emerging inflammatory biomarker, predicted cardiovascular events in population-based studies. Psoriasis, an inflammatory disease associated with increased cardiovascular risk, provides a model to study inflammatory biomarkers in cardiovascular disease (CVD). Whether GlycA associates with psoriasis and how it predicts subclinical CVD beyond hsCRP in psoriasis is unknown. Objective To investigate the relationships between GlycA and psoriasis, and between GlycA and subclinical CVD. Methods and Results Psoriasis patients and controls (n=412) participated in a two-stage study. We measured GlycA by NMR spectroscopy. NIH participants underwent 18-FDG PET/CT scans to assess vascular inflammation (VI) and coronary CT angiography to quantify coronary artery disease (CAD) burden. Psoriasis cohorts were young (mean age=47.9), with low cardiovascular risk and moderate skin disease. HsCRP and GlycA were increased in psoriasis compared to controls [GlycA: (PENN: 408.8±75.4 vs. 289.4±60.2, p<0.0001, NIH: 415.8±63.2 vs. 346.2±46, p<0.0001)] and demonstrated a dose-response with psoriasis severity. In stage 2, VI (β=0.36, p<0.001) and CAD (β=0.29, p=0.004) associated with GlycA beyond CV risk factors in psoriasis. In ROC analysis, GlycA added value in predicting VI (p=0.01) and CAD (p<0.01). Finally, initiating anti-TNF therapy (n=16) reduced psoriasis severity (p<0.001), GlycA (463.7±92.5 vs. 370.1±78.5; p<0.001) and VI (1.93±0.36 vs. 1.76±0.19; p<0.001), while GlycA remained associated with VI (β=0.56, p<0.001) post-treatment. Conclusions GlycA associated with psoriasis severity and subclinical CVD beyond traditional CV risk and hsCRP. Moreover, psoriasis treatment reduced GlycA and VI. These findings support the potential utility of GlycA in subclinical CVD risk assessment in psoriasis and potentially other inflammatory diseases.

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The impact of psoriasis on 10-year Framingham risk

Cited by 51 publications

References 5 publications

Incidence and predictors for cardiovascular events in patients with psoriatic arthritis

Incidence and predictors for cardiovascular events in patients with psoriatic arthritis

Psoriasis and comorbid diseases

GlycA Is a Novel Biomarker of Inflammation and Subclinical Cardiovascular Disease in Psoriasis

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