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Subclinical cardiovascular disease in plaque psoriasis: Association or causal link? |
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| Authors: | Sameer Shaharyar Haider Warraich John W McEvoy Ebenezer Oni Shozab S Ali Adil Karim Omar Jamal Michael J Blaha Roger S Blumenthal Jonathan Fialkow Ricardo Cury Matthew J Budoff Arthur A Agatston Khurram Nasir |
| Institution: | 1. Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, FL, USA;2. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;3. Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA;4. The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA;5. Baptist Hospital of Miami and Baptist Cardiac & Vascular Institute, Miami, FL, USA;6. Los Angeles Biomedical Research Institute, UCLA Harbor Medical Center, CA, USA;g Department of Radiology, Florida International University, Miami, FL, USA;h Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA |
| Abstract: | BackgroundPsoriasis patients have a high prevalence of cardiovascular events and are thought to have a relative risk increase of 25% as compared to the general population. However, a causal relationship between psoriasis and cardiovascular disease has not been established. We sought to perform a systematic review of existing data regarding the presence of endothelial dysfunction and subclinical atherosclerosis in patients with plaque psoriasis.MethodsA systematic literature search was performed, using Medline database and Ovid SP for relevant literature up to November 2012. Twelve studies met inclusion criteria from an initial search result of 529 articles.ResultsAmong the twelve studies meeting inclusion criteria, two (17%) reported increased mean coronary artery calcification (CAC) in psoriatic patients. Six studies (50%) showed carotid intima–media thickness CIMT] increase in psoriasis. Five studies (42%) examined flow mediated dilation FMD], of which three showed decreased FMD in psoriasis patients. One study (8%) each demonstrated a decreased coronary flow reserve and increased arterial stiffness as assessed by pulse wave velocity.ConclusionsPatients with psoriasis have an increased burden of subclinical atherosclerosis and endothelial dysfunction. Patients with greater severity and/or disease duration should be targeted for primary screening for cardiovascular disease risk reduction |
| Keywords: | Psoriasis Atherosclerosis Sub-endothelial dysfunction Coronary artery calcium Primary prevention Carotid intima&ndash media thickness |
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