MedWire News: Researchers have found further evidence to support a link between psoriasis and subclinical atherosclerosis in patients without clinically evident cardiovascular disease or other cardiovascular risk factors.
H Fathy and team, from Mansoura University in Egypt, agree with other studies previously reported by MedWire News that “both diseases share common inflammatory cytokine profiles locally and systemically.”
They explain: “The activation of the inflammatory process and upregulation of T-helper-1 mediated cytokine cascades, with interferon gamma, tumor necrosis factor-α, interleukin (IL)-1 and 6, is a probable trigger for acute coronary syndrome, as well as psoriasis.”
Fathy et al measured carotid artery intima-media thickness (IMT) in 80 patients with chronic psoriasis (mean Psoriasis Area and Severity Index [PASI] score of 29.1) and 50 controls without the skin disease matched for age and gender.
Patients with psoriasis had an average carotid artery IMT of 0.9 mm, compared with 0.7 mm for controls. Carotid plaques were also more common in psoriasis patients than controls, at 27.8% and 14.0%, respectively, but the difference did not reach statistical significance.
The researchers note in the Journal of the European Academy of Dermatology and Venereology that there was a strong positive association between carotid IMT in psoriasis patients and duration of the disease and PASI score.
Overall, age was the strongest predictor of carotid IMT, followed by PASI score. However, carotid IMT was not significantly correlated with markers of systemic inflammation.
Fathy and team were able to rule out possible silent echocardiographic abnormalities as an explanation for the association between carotid IMT and psoriasis. There was no significant difference in echocardiographic parameters between patients and controls and no correlation between carotid IMT and such parameters in psoriasis patients.
They conclude: “There is increased frequency of subclinical atherosclerotic macrovascular disease in patients with chronic psoriasis. So, older patients with severe psoriasis need frequent follow-up to reduce cardiovascular morbidity and mortality.
“Moreover, further studies are needed to evaluate if treatment of severe psoriasis decreases cardiovascular risk and atherosclerosis.”
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