Coronary artery diseaseCoronary Artery Disease in Patients With Psoriasis Referred for Coronary Angiography
Section snippets
Methods
We identified all patients who underwent cardiac catheterization at the University of California, Davis from 2004 through 2009. This database contains prospective data entered at the time of cardiac catheterization including patient risk factors, medical history, and quantitative results of coronary angiography. Patients were included if they were ≥18 years of age and had undergone coronary angiography from 2004 through 2009. This study was approved by the University of California, Davis,
Results
From a total population of 9,473 patients who underwent coronary angiography, we identified 204 patients (2.2% of overall population) who had psoriasis before coronary angiography (Table 1). Compared to the overall population, patients with psoriasis had a higher body mass index (31.3 ± 8.1 vs 29.3 ± 7.1 kg/m2, p <0.001) and were more likely to have a history of hypercholesterolemia (72% vs 66%, p = 0.06). Eighteen percent of patients with psoriasis had previous myocardial infarction and 45% of
Discussion
This analysis represents the first systematic study of the prevalence of angiographically confirmed CAD in psoriasis patients referred for coronary angiography. Three important findings emerge from this study. First, patients with psoriasis have an increased prevalence of cardiovascular risk factors even compared to an otherwise high-risk cohort. Second, patients with psoriasis are more likely to have CAD as visualized on coronary angiogram even after adjusting for established cardiovascular
References (23)
- et al.
Prevalence of cardiovascular risk factors in patients with psoriasis
J Am Acad Dermatol
(2006) - et al.
Coronary heart disease and stroke risk in patients with psoriasis: retrospective analysis
Am J Med
(2010) - et al.
Circulating levels of adiponectin, oxidized LDL and C-reactive protein in Portuguese patients with psoriasis vulgaris, according to body mass index, severity and duration of the disease
J Dermatol Sci
(2009) - et al.
Angiogenesis and oxidative stress: common mechanisms linking psoriasis with atherosclerosis
J Dermatol Sci
(2011) - et al.
Enhanced T-helper-1 lymphocyte activation patterns in acute coronary syndromes
J Am Coll Cardiol
(2005) - et al.
AJC editor's consensus: psoriasis and coronary artery disease
Am J Cardiol
(2008) - et al.
Usefulness of the Framingham risk score in patients with chronic psoriasis
Am J Cardiol
(2010) - et al.
National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening
J Am Acad Dermatol
(2008) - et al.
Patterns in visual interpretation of coronary arteriograms as detected by quantitative coronary arteriography
J Am Coll Cardiol
(1991) - et al.
Methods of covariate selection: directed acyclic graphs and the change-in-estimate procedure
Am J Epidemiol
(2009)
Risk of myocardial infarction in patients with psoriasis
JAMA
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This work was supported by the Dermatology Foundation, Evanston, Illinois. Dr. Rogers is a consultant for Volcano, Medtronic, Cordis and Boston Scientific. Dr. A.W. Armstrong is an investigator and consultant for Abbott and Centocor.