LUGO, Spain—Psoriatic arthritis (PsA) patients without traditional cardiovascular risk factors are more likely to have subclinical macrovascular atherosclerotic disease than are their counterparts without PsA, according to a new study in Arthritis & Rheumatism.1

"This is very similar to RA where inflammation is linked to the high incidence of cardiovascular disease in the absence of traditional risk factors and is very clinically relevant."—Vibeke Strand, MD.
Researchers noninvasively measured the carotid plaques in the right common carotid artery using high-resolution B-mode ultrasound in 59 PsA patients and 59 healthy, ethnically-matched controls. Patients with PsA showed greater carotid artery intimamedia thickness (IMT) than matched controls (P = .031). PsA patients also had more carotid plaques than controls, but this difference was not statistically significant (P = .068).

Prolonged PsA may promote atherosclerosis

Among PsA patients, the carotid IMT correlated with age at the time of PsA diagnosis (P = .04), disease duration (P = .04), total cholesterol (P = .01), and low-density lipoprotein cholesterol (P = .01). As shown in patients with rheumatoid arthritis (RA), prolonged disease duration in patients with PsA may promote the development of atherosclerosis, write researchers led by Carlos Gonzalez-Juanatey, MD, PhD, of the Hospital Xeral-Calde, in Lugo, Spain.

The new study findings regarding cholesterol levels in PsA patients as well as other research "may support a potential role for statins in the treatment of patients with chronic inflammatory rheumatic diseases," the study authors point out. Furthermore, the researchers found no association between use of steroid and carotid IMT among the 34 PsA patients who were taking prednisone.

"This is in accordance with recent studies that challenge the classic assumption that glucocorticoids are responsible for a proatherogenic effect in patients with rheumatic diseases," they note.

Untreated inflammation increases risk for atherosclerosis

"This is very similar to RA where inflammation is linked to the high incidence of cardiovascular disease in the absence of traditional risk factors and is very clinically relevant," said Vibeke Strand, MD, adjunct clinical professor of immunology/rheumatology at Stanford University, in Palo Alto, California. She told CIAOMed that statins are warranted in these patients and many are receiving these drugs now. "Ditto for lymphomas as well as in PsA, which are again linked to inflammation/proliferation," she added.

Reference

1. Gonzalez-Juanatey C, Llorca J, Amigo-Diaz E, et al. High prevalence of subclinical atherosclerosis in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors. Arthritis Rheum. 2007;57:1074-1080.