Objectives To evaluate coronary atherosclerosis in patients with psoriatic arthritis (PsA) and control subjects using coronary CT angiography (CCTA).
Methods Ninety consecutive patients with PsA (male: 56(62.2%); 50.3±11.1 years) were recruited. 240 controls (male: 137(57.1%); 49.6±10.7 years) without known cardiovascular (CV) diseases who underwent CCTA due to chest pain and/or multiple CV risk factors were recruited for comparison.
Results Patients with PsA and controls were matched in age, gender and traditional CV risk factors (all p>0.2). The prevalence of overall plaque (54(60%)/84(35%), p<0.001), calcified plaque (CP) (29(32%)/40(17%), p=0.002), mixed plaque (MP) (20(22%)/18(8%), p<0.001), non-calcified plaque (NCP) (39(43%)/53(22%), p<0.001) and combined MP/NCP (46(51%)/62(26%), p<0.001) were all significantly higher in patients with PsA. Three-vessel disease was diagnosed in 12(13%) patients with PsA and 7(3%) controls (p<0.001), while obstructive plaques (>50% stenosis) were observed in 8(9%) patients with PsA and 7(3%) controls (p=0.033). After adjusting for traditional CV risk factors, PsA remained an independent explanatory variable for all types of coronary plaques (OR: 2.730 to 4.064, all p<0.001). PsA was also an independent explanatory variable for three-vessel disease (OR: 10.798, p<0.001) and obstructive plaque (3.939, p=0.024). In patients with PsA, disease duration was the only disease-specific characteristic associated with more vulnerable plaques (MP/NCP) in multivariate analysis (1.063, p=0.031). The other independent explanatory variables were age ≥55 years (5.636, p=0.005) and male gender (8.197, p=0.001).
Conclusions Patients with PsA have increased prevalence, burden and severity of coronary atherosclerosis as documented by CCTA. Longer disease duration was independently associated with the presence of vulnerable MP/NCP plaques in patients with PsA.
Trial registration number NCT02232321.
- Psoriatic Arthritis
- Cardiovascular Disease
Statistics from Altmetric.com
Handling editor Tore K Kvien
Contributors L-ST had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. LST, KTW and JS: study design. L-ST, K-TW, ITC, QS, EKL, PW, EWK, MYL, YR, IY, SY, ML, TKL, C-KW, TYZ, MC and AP-WL: acquisition of data. L-ST, JS, ITC and JJ-WL: analysis and interpretation of data. JS and L-ST: manuscript preparation.
Funding Health and Medical Research Fund (01120496).
Competing interests None declared.
Ethics approval Joint Chinese University of Hong Kong—New Territories East Cluster Clinical Research Ethics Committee (the Joint CUHK-NTEC CREC).
Provenance and peer review Not commissioned; externally peer reviewed.