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

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.

Uveitis in psoriatic arthritis: study of 406 patients in a single university center and literature review

“… 42 Ferraz-Amaro et al have found a relationship between the presence of CV risk factors and increased inflammatory activity in a cross-sectional study of patients with PsA. 43 Although our results have suggested that uveitis is associated with higher inflammatory burden (reflected by a higher prevalence of sacroiliitis) we have not found a significant association between CV risk factors and uveitis.…”

Cardiovascular risk factors are negatively associated with rheumatoid arthritis disease outcomes

“…In a recent study, PsA patients with >3 CVD risk factors had the highest adjusted disease activity compared with those with fewer or no CVD risk factors. 22 Cardiometabolic conditions are over-represented in PsA and the prevalence of CVD risk factors was 73% in this cohort, compared with 50% in our study. While the different populations and disease outcomes studied limit our ability to make direct comparisons, these findings underscore the influence that burden of CVD comorbidity may exert on inflammatory arthritis course and is worthy of investigation in other RA and PsA cohorts.…”

Management of Psoriatic Arthritis in Patients With Comorbidities: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations

“…3 Additionally, several studies have suggested that the greater the disease activity, the greater cardiovascular (CV) risk, independent of disease duration and other demographic factors. 4 Disease Activity in Psoriatic Arthritis (DAPSA) score increases were associated with a higher number of CV risk factors. 4 In patients with established CVD (coronary artery disease, previous strokes, and/or myocardial infarctions), nonsteroidal antiinflammatory drugs (NSAIDs) pose a challenge.…”

“…4 Disease Activity in Psoriatic Arthritis (DAPSA) score increases were associated with a higher number of CV risk factors. 4 In patients with established CVD (coronary artery disease, previous strokes, and/or myocardial infarctions), nonsteroidal antiinflammatory drugs (NSAIDs) pose a challenge. 5 All NSAIDs confer the same risk of CV events, which should be considered when prescribing these drugs.…”