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Research ArticlePsoriatic Arthritis

Role of Carotid Ultrasound and Systematic Coronary Risk Evaluation Charts for the Cardiovascular Risk Stratification of Patients with Psoriatic Arthritis

María Paz Martínez-Vidal, Mariano Andrés, Vega Jovaní, Carlos Santos-Ramírez, Cintia Romera and Cristina Fernández-Carballido
The Journal of Rheumatology May 2020, 47 (5) 682-689; DOI: https://doi.org/10.3899/jrheum.181223
María Paz Martínez-Vidal
From the Hospital General Universitario de Alicante, Alicante; Hospital Virgen de los Lirios, Alcoy; Hospital del Vinalopó, Elche; and Hospital General Universitario de San Juan, Alicante, Spain.
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  • For correspondence: mpmavidal@yahoo.es
Mariano Andrés
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Vega Jovaní
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Carlos Santos-Ramírez
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Cintia Romera
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Cristina Fernández-Carballido
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Abstract

Objective. The assessment of the cardiovascular (CV) risk is recommended in patients with chronic inflammatory rheumatic diseases. The objectives of this study were to assess the CV risk profile in a cohort of patients with psoriatic arthritis (PsA), to determine the presence of subclinical cardiovascular disease by carotid ultrasound (US), and to study the association of CV disease to PsA characteristics.

Methods. This was a cross-sectional multicentric descriptive study. The clinical CV risk was calculated with Systematic Coronary Risk Evaluation (SCORE) charts. Common carotid US was conducted to evaluate the carotid wall intima-media thickness and the presence of atheroma plaques. Patients were reclassified upon US results. Multivariate analyses were performed to identify associations of US carotid abnormalities with the classical CV risk factors and PsA characteristics.

Results. The study included 176 patients with PsA. The SCORE-estimated CV risk was intermediate in 65.3% of the patients. In the US study, 32% of the patients had abnormalities, and 30.8% of the patients were upgraded and reclassified as very high risk owing to the presence of atheroma. Subclinical CV disease was associated with age and dyslipidemia but not with other risk factors. It was associated with axial disease in the subgroup with intermediate risk, and with C-reactive protein levels in patients with high risk.

Conclusion. Many patients with PsA have clinical estimated intermediate or high risk of a fatal CV event. A carotid US study detects subclinical vascular disease and may be useful to depict the real risk. The presence of atheroma is only partially explained by the classic CV risk factors.

Key Indexing Terms:
  • PSORIATIC ARTHRITIS
  • CARDIOVASCULAR RISK
  • ULTRASOUND
  • CAROTID PLAQUE

Footnotes

  • Supported by institutional funding from the Sociedad Valenciana de Reumatología.

  • Accepted for publication May 23, 2019.
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The Journal of Rheumatology
Vol. 47, Issue 5
1 May 2020
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Role of Carotid Ultrasound and Systematic Coronary Risk Evaluation Charts for the Cardiovascular Risk Stratification of Patients with Psoriatic Arthritis
María Paz Martínez-Vidal, Mariano Andrés, Vega Jovaní, Carlos Santos-Ramírez, Cintia Romera, Cristina Fernández-Carballido
The Journal of Rheumatology May 2020, 47 (5) 682-689; DOI: 10.3899/jrheum.181223

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Role of Carotid Ultrasound and Systematic Coronary Risk Evaluation Charts for the Cardiovascular Risk Stratification of Patients with Psoriatic Arthritis
María Paz Martínez-Vidal, Mariano Andrés, Vega Jovaní, Carlos Santos-Ramírez, Cintia Romera, Cristina Fernández-Carballido
The Journal of Rheumatology May 2020, 47 (5) 682-689; DOI: 10.3899/jrheum.181223
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Keywords

PSORIATIC ARTHRITIS
CARDIOVASCULAR RISK
ULTRASOUND
CAROTID PLAQUE

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Keywords

  • psoriatic arthritis
  • CARDIOVASCULAR RISK
  • ultrasound
  • CAROTID PLAQUE

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