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Abstract Number: 1589

Cardiac Biomarkers and Carotid Atherosclerosis and Its Progression in Psoriatic Disease

Lihi Eder1, Vinod Chandran2, Iain B. McInnes3, Richard J. Cook4, Dafna D Gladman5, Paul Welsh6, Naveed Sattar7 and Paula Harvey8, 1Women's College Research Institute, University of Toronto, Women's College Hospital, Toronto, ON, Canada, 2Krembil Research Institute & University of Toronto, Toronto, ON, Canada, 3University of Glasgow, Glasgow, United Kingdom, 4Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada, 5Rheumatology, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 6nstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom, 7Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom, 8Cardiology, Women's College Hospital, University of Toronto, Toronto, ON, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Atherosclerosis, Biomarkers, Cardiovascular disease, psoriasis and psoriatic arthritis

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Session Information

Date: Monday, October 22, 2018

Session Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Clinical/Epidemiology Studies

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Laboratory biomarkers indicative of cardiac ischemia or dysfunction improve cardiovascular (CV) risk stratification in the general population. Their utility in patients with psoriatic disease (PsD) is unknown. Our objective was to evaluate the levels of cardiac biomarkers in patients with PsD vs. non-psoriatic controls and to assess their association with the burden of carotid atherosclerosis and plaque progression.

Methods: Patients with psoriasis only (PsC) or psoriatic arthritis (PsA) from a longitudinal PsD cohort were enrolled. Non-psoriatic controls were recruited through advertisements and from hospital personnel. Baseline evaluation included clinical assessment of CV risk factors, joint and skin disease activity and medication use. Ultrasound assessment of the carotid arteries was performed only in patients with PsD. Total Plaque Area (TPA) was measured at baseline and after 2-3 years. The average annual progression rate of atherosclerosis was calculated by subtracting the baseline from the follow-up TPA divided by the number of years between the visits. Concentrations of high sensitivity Troponin I (TNT-I) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using automated clinical assays. The association between cardiac biomarkers and carotid atherosclerosis was assessed by multivariable regression analysis after adjusting for age, sex, diabetes, hypertension, smoking, BMI, lipid lowering therapy, LDL-c, HDL-c and creatinine.

Results: A total of 391 patients with PsD (71% PsA, 29% PsC) and 88 controls were included. Their mean age was 54.1±11.7 years (53.4% men). Unadjusted levels of TNT-I were higher in patients with PsD compared to controls (Odd Ratio (OR) 1.41, 95% Confidence Interval (CI) 1.11, 1.81), however, after controlling for age, sex and creatinine levels, no significant differences were found. The unadjusted and adjusted levels of NT-proBNP were similar in patients with PsD and controls. Higher levels of NT-Pro-BNP were associated with PsA vs. PsC (adjusted OR 1.35, 95% CI 1.09, 1.68). Higher levels of TNT-I were associated with the burden of carotid atherosclerosis at baseline in unadjusted models (β 0.66, 95% CI 0.46, 0.87; Table 1) and after controlling for CV risk factors (adjusted β 0.27, 95% CI 0.08, 0.46; Table 1). However, baseline TNT-I levels did not predict carotid atherosclerosis progression (p=0.47). No significant association was found between baseline levels of NT-proBNP and carotid atherosclerosis at baseline (adjusted P=0.15) or the rate of atherosclerosis progression (adjusted p=0.64). No interaction was found between each of the biomarkers and sex.

Conclusion: Higher TNT-I is associated with more pronounced atherosclerosis in patients with PsD independently of usual CVD risk factors. The utility of hsTnI in improving CV risk stratification in these PsD patients warrants assessment.  


 

Table 1 – The Association between Troponin I levels and Total Plaque Area* at Baseline by Linear Regression Model in Patients with Psoriatic Disease (N=391)

Variable

Adjusted β

95% Confidence Interval

P value

High-Sensitivity Troponin I* (ng/L)

0.27

0.08, 0.46

0.006

Age (10 year increase)

0.06

0.05, 0.07

<0.001

Sex: Female

-0.18

-0.49, 0.12

0.25

BMI (kg/m2)

0.01

-0.01, 0.04

0.32

Hypertension (y/n)

0.22

-0.11, 0.56

0.18

Diabetes (y/n)

0.24

-0.30, 0.78

0.38

Smoking (Current vs. No)

0.46

0.04, 0.88

0.03

LDL-c (mmol/L)

0.27

0.12, 0.42

<0.001

HDL-c (mmol-L)

0.002

-0.37, 0.38

0.99

Use of lipid lowering drugs (y/n)

0.68

0.36, 1.01

<0.001

Creatinine (μmol/L)

0.21

-0.62, 1.05

0.61

*log transformed

 


Disclosure: L. Eder, None; V. Chandran, None; I. B. McInnes, None; R. J. Cook, None; D. D. Gladman, None; P. Welsh, None; N. Sattar, None; P. Harvey, None.

To cite this abstract in AMA style:

Eder L, Chandran V, McInnes IB, Cook RJ, Gladman DD, Welsh P, Sattar N, Harvey P. Cardiac Biomarkers and Carotid Atherosclerosis and Its Progression in Psoriatic Disease [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/cardiac-biomarkers-and-carotid-atherosclerosis-and-its-progression-in-psoriatic-disease/. Accessed May 25, 2022.
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