Imaging Tests Help Reveal Heart Risks in Patients With Psoriatic Disease

June 6, 2019

Combining vascular imaging data with information on cardiovascular risk factors may improve the accuracy of cardiovascular risk stratification in patients with psoriatic disease, according to a study published in Arthritis & Rheumatology.

For the study, Curtis Sobchak, University of Toronto, Toronto, Canada, and colleagues assessed 559 patients with psoriatic disease. The patients underwent ultrasound assessment of the carotid arteries at baseline. The extent of atherosclerosis was assessed using carotid intima media thickness and total plaque area. Incident cardiovascular events that occurred following the ultrasound assessment were identified.

During the follow-up period, 23 patients experienced an incident cardiovascular event.

The researchers found that the calculated rate of developing first cardiovascular event during the study period was 1.11 events per 100 patient years (95% confidence interval [CI], 0.74-1.67).

When analysed separately, total plaque area (hazard ratio [HR] = 3.74; 95% CI, 1.55-8.85; P = .003), mean carotid intima media thickness (HR = 1.21; 95% CI, 1.03-1.42; P = .02), max carotid intima media thickness (HR = 1.11; 95% CI, 1.01-1.22; P = .03), and high total plaque area category (HR = 3.25; 95% CI, 1.18-8.95; P = .02) predicted incident cardiovascular events after controlling for Framingham Risk Score.

The findings suggest that combining such imaging data with clinical and laboratory measures of traditional cardiovascular risk factors could improve risk predictions and identify which patients with psoriatic disease might benefit from more intensive heart-protective therapies.

“Ultrasound is widely used in rheumatology settings as a point of care to detect joint inflammation,” concluded Lihi Eder, MD, University of Toronto. “Our study suggests that ultrasound can also be used to identify patients at high cardiovascular risk who may be missed by conventional methods, [allowing for] early intervention.”