Background Psoriatic arthritis (PsA) is characterized by increased cardiovascular morbidity and mortality . Data about clinical features related with endothelial dysfunction and atherosclerosis in PsA are limited. Uveitis is an extraarticular feature of PsA that is connected with arterial lesion and considered to be a factor associated with adverse cardiovascular prognosis.
Objectives The aim of the study was to detect the relationship between presence of uveitis, increase arterial stiffness and atherosclerosis of carotids in patients with PsA.
Methods In total, 65 patients with PsA without cardiovascular diseases and 20 healthy volunteers were involved in the study (mean age±SD was 41.62±10.2 and 41.33±13.8 years, respectively). 11 patients with PsA had uveitis, confirmed by an ophthalmologist. Arthritis activity assessment was performed by means of the disease activity score (DAS), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) measurements. Main cardiovascular risk factors (age, gender, smoking, family history, arterial hypertension, body mass index (BMI)) were screened. Patients with and without uveitis were comparable in convectional cardiovascular risk factors and disease activity. Arterial stiffness parameters were performed by the pulse wave analysis: augmentation index (Aix) was calculated. Aix wasseen as optimal; - 30% s normal; -10 10% - increased; Aix >10% of pathological. The ultrasound measuring the thickness of intima-media layer (IMT) in carotid arteries (CA) was performed for atherosclerosis detection.
Results In patients with uveitis an increase of Aix as compared to PsA patients without uveitis was found. Aix in uveitis patients was 4.6 [-18.3; 4.1] %, in patients without uveitis - 34.5 [-20.1; -43.3] %, p=0.02, in controls Aix =-40.48[-56; -19] %, p
IMT of right CA in patients with uveitis exceeded IMT patients without uveitis (0.6 [0.5; 0.7] vs. 0.4 [0.4; 0.6] mm, respectively). Mean IMT in patients with uveitis was 0.68 [0.53; 0.85] mm, n=11, without uveitis – 0.43 [0.4; 0.53] mm, n=54, p=0.03. In healthy controls IMT was 0.51 [0.5; 0.7] mm, n=20, p
Conclusions Uveitis in psoriatic arthritis patients without cardiovascular diseases was associates with increased arterial stiffness and carotid intima-media layer thickening and could, therefore, serve as a marker of worse cardiovascular prognosis in this population.
Gladman D.D. et al. Arthritis Rheum.-1998.-Vol.41.- P.1103-1010.
Disclosure of Interest None Declared