Effect of psoriasis on cardiovascular risk

Abstract

BACKGROUND: According to modern data, psoriasis is an immune-mediated disease of a multifactorial nature, affecting not only the skin, but also associated with the development and worsening of the course of diseases of the cardiovascular system. Given the systemic nature of psoriasis, a targeted study of this problem is necessary.

AIM: The aim of this study is to establish the relationship between psoriasis and cardiovascular disease.

MATERIALS AND METHODS: The main group consisted of 160 patients diagnosed with psoriasis, 40 patients were included in the comparison group. Inclusion criteria for the study: age over 18 years, signed informed consent to participate. The exclusion criteria were pregnancy and the patient's refusal to participate further. An open prospective observational clinical study was conducted. The total duration of the study and follow-up was 1 year. All patients had total cholesterol, glucose, creatinine, C-reactive protein measured and calculation of glomerular filtration rate done performed. Body mass index, blood pressure according to Korotkov method, severity of psoriasis (PASI), and dermatological quality of life index (DLQI) were also assessed (by HADS, Hamilton, Zang scales). The psycho-emotional state was assessed, the smoking and the presence of diabetes mellitus were taken into account. Cardiovascular risk was calculated using the SCORE2/2OP scale. In the case of a high cardiovascular risk and/or detection of previously undiagnosed cardiovascular disease, patients were admitted to hospital. All patients received optimal medical and topical therapy.

Patients were followed up during hospitalization and/or telephone calls one year after enrollment in the study.

RESULTS: Among the patients of the main group, from 19 to 85 years old, of which 61% were men and 39% were women, mild psoriasis was diagnosed in 6.2%, moderate in 40%, and severe in 53.8%. Low cardiovascular risk was determined in 39%, moderate in 14%, high in 47%. Among patients in the control group, from 24 to 81, of which 30% are men and 70% are women. Of these, 65% had a low cardiovascular risk, moderate in 5%, and a high in 30%. According to the results of the correlation analysis, there were no statistically significant results on the relationship between psoriasis and cardiovascular disease, however, a multivariate ROC analysis revealed a combined effect of gender, height, weight, body mass index, age, cholesterol level, PASI and DLQI index on the likelihood of development and/or worsening the course cardiovascular disease (AUC 0.9258).

CONCLUSION: Our study provides evidence for a potential causal relationship between psoriasis and cardiovascular disease. Thus, early assessment of CV risk and prevention of the development and worsening of cardiovascular disease requires careful attention from healthcare professionals within multidisciplinary teams.

Keywords

psoriasis / cardiovascular risk / cardiovascular disease / myocardial infarction / stroke / hypertension / inflammation

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