Background/Purpose: Psoriatic arthritis (PsA) is associated with increased cardiovascular (CV) morbidity and mortality. Assessing individual CV risk and achieving the recommended LDL-cholesterol (LDL-C) target could contribute to reduce the burden of CV disease in PsA. Aims: To compare the prevalence of CV risk factors (CVRFs) and history of CV disease (CVD) among French PsA patients and age- and sex-matched controls; to quantify individual CV risk using SCORE, QRISK2 and REYNOLDS risk scores; to assess the proportion of PsA patients or controls achieving the recommended LDL-C target according to their individual CV risk.

Methods: Observational case-control single-site study. PsA patients (CASPAR criteria), consulting a rheumatologist or hospitalized in the Rheumatology Department of a French University Hospital between March 2016 and January 2017, were included in the study after informed consent was obtained. Age- and sex-matched controls (2:1) were extracted from the Mona Lisa, general population study. CVRF and history of CVD were collected and compared between PsA patients and controls. Individual CV risk was quantified, using SCORE (with or without using a 1.5 multiplication factor), QRISK2 (with or without including PsA as a CVRF) and REYNOLDS risk scores and compared between PsA patients and controls. The proportion of PsA patients or controls achieving the recommended LDL-C target according to their individual CV risk was assessed.

Results: 207 PsA patients and 414 controls were included in this study. CVRF and history of CVD were significantly increased in PsA patients in comparison with controls (Table1). Individual CV risk was higher in PsA patients in comparison with controls using SCORE (p=0.002), QRISK2 (p=0.001) and REYNOLDS (p=0.003) risk scores (data not shown). The proportion of PsA patients or controls achieving the recommended LDL-C target according to their individual CV risk, quantified using SCORE, was low in both groups (Table 2). Among PsA patients or controls with an individual risk score ³ 10%, quantified using QRISK2, only 22.9% or 35.8% were respectively treated with a statin.

Conclusion: Our study confirms that the prevalence of CVRF and history of CVD is higher in PsA patients than in controls. It shows that individual CV risk is higher in PsA patients than in controls, whatever risk score is used for its quantification. It highlights that a low proportion of PsA patients achieve LDL-C target (SCORE) or initiate a treatment with a statin (QRISK2) in spite of high individual CV risk.

Table 1. CVRF and history of CVD in PsA patients and controls

Table 2: Proportion of PsA patients or controls achieving LDL-C target (SCORE)