The rheumatology service of the Marqués de Valdecilla University Hospital, in collaboration with the dermatology, internal medicine and statistical service, has carried out a cross-sectional study on psoriatic arthritis in collaboration with the University Hospital of the Canary Islands. This study has been published in The Journal of Rheumatology.
The addition of carotid ultrasound in composite cardiovascular risk scores (CRV) has been found effective in identifying patients with inflammatory arthritis and C-reactive protein (CRP). Therefore, the objective of the study was to determine if its use would facilitate the reclassification of patients with psoriatic arthritis (PsA) in the SCORE (Systematic Coronary Risk Assessment) category of very high risk and if this could be related to the characteristics of the disease.
A total of 206 patients participated in this cross-sectional study, which met CASPAR criteria for psoriatic arthritis (PsA) compared to 197 controls. The following variables were evaluated in the study: lipid profile, SCORE, peripheral articular activity index as axial (DAPSA, BASDAI and BASFI) and skin activity indices: PASI, NAPSI, BSA, and the presence of plaques was measured. Carotid and thickening of the intimate media through ultrasound (surrogate marker). In the study, a multivariable regression analysis was carried out adjusting the classic cardiovascular values and the risk was reclassified, taking into account the results of the carotid and clinical measurement in terms of disease activity.
The results have been that 49% of patients with psoriatic arthritis had carotid plaques compared to 26% of controls, therefore, these patients were reclassified at very high risk according to the SCORE, although they were classified as patients with a low cardiovascular risk, and being well controlled for cardiovascular risk factors, with respect to controls.
In conclusion: Patients with psoriatic arthritis are reclassified, at very high risk in the SCORE after performing the carotid ultrasound, which is explained independently of the disease activity.
Ref. Disease Activity Influences Cardiovascular Risk Reclassification Based on Carotid Ultrasound in Patients with Psoriatic Arthritis. Natalia Palmou-Fontana, David Martínez-Lopez, Alfonso Corrales, Javier Rueda-Gotor, Fernanda Genre, Susana Armesto, Marcos A. González-López, Juan C. Quevedo-Abeledo, Virginia Portilla-González, Ricardo Blanco, José L. Hernandez, Javier Llorca, Miguel Á. González-Gay and Iván Ferraz-Amaro. The Journal of Rheumatology November 2019, jrheum.190729; DOI: https://doi.org/10.3899/jrheum.190729
