Background/Purpose: SCORE tables underestimate the Cardiovascular Risk (CVR) for patients with Rheumatoid Arthritis (RA) and EULAR recommends multiplying by 1.5 the CVR obtained from them in RA patients [1]. A concern exists that CVR in Psoriatic Arthritis (PsA) might be underestimated [2,3]. Several studies show that the carotid intima-media thickness (CIMT) and the presence of cholesterol plaques (CP) detected with Ultrasound (US) are significantly associated with CVR [4,5]. The objective of this study was too assess the CVR profile in PsA patients using the SCORE/European recommendations, and to study the presence of subclinical CV disease by US techniques.

Methods: Transversal descriptive multicenter study of PsA patients followed up in Rheumatology Units. Variables: Age, gender, psoriasis and PsA duration, PsA type and therapy; classic CVR factors (BMI, hypertension, dyslipidaemia, smoking, diabetes); prevalent personal and familiar CV events (coronary, cerebrovascular and thromboembolic events, sudden death). The probability of fatal atherosclerotic CV events over a 10 year period was calculated (Spanish SCORE chart/European recommendations). Then all patients underwent bilateral US carotid study (GE LOGIQ S7 Expert US Equipment). The common CIMT was measured in both common carotids using an automatized lecture of the distal intima-media wall in a surface of 1.39 cm or 300 points, 1 cm caudal to the carotid bulb. Plaques were defined according to the Mannheim consensus [6]. Statistical analysis: Descriptive, univariate and multivariate analyses (ANOVA) were performed.

Results: 176 PsA patients from three hospitals were included: mean age 55.2 yo (SD11.8) (50.6% male). Clinical characteristics summarized in Table 1. 62% of the patients had at least one classical CV risk factor. In the US study, a CIMT greater than 0.9 mm or the presence of plaques were found in 55 patients (31.2%). Cardiovascular Risk was upgraded to very high because of the US results in 53 patients (30.1%). Finally, 33.5% of the patients were considered as very high risk. The risk distribution before and after the US study is depicted in Table 2.

Conclusion: CV risk factors are frequent among PSA patients. A substantial proportion of patients with PsA are at a very high risk of a fatal CV event. The SCORE/European classification seems to underestimate the CV risk, as 30.1% of the patients were upgraded to a higher risk after the US study.

Table 1. Clinical characteristics of the PsA patients included

Table 2. CV risk stratification according to the SCORE tables/European recommendations and after the carotid US study.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-cardiovascular-risk-factors-and-subclinical-cardovacular-disease-in-psoriatic-arthritis/