Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Hypertension and Diabetes Significantly Enhance the Risk for Cardiovascular Disease in Patients with Psoriasic Arthritis (PsA).

Favarato1,  Maria Helena Sampaio, Saad2,  Carla Gonçalves, Goncalves2,  Célio Roberto, Sampaio-Barros2,  Percival Degrava, Goldenstein-Schainberg2,  Claudia

Rheumatology, HC-FMUSP, São Paulo, Brazil
Rheumatology, HC-FMUSP

New evidence has lightened the linkage between psoriatic arthritis (PsA) and the development of atherosclerosis and cardiovascular disease (CVD) events.

Objective:

To describe the prevalence of cardiovascular events and associated risk factors among patients with PsA from a tertiary hospital.

Methods:

Retrospective evaluation of medical records from all current patients who fulfilled the CASPAR criteria for PsA attending a specialized spondyloarthritis clinic at a universitary tertiary hospital.

Results:

158 PsA patients, 48.73% females and 51.27% males, aged 53.67 ± 13.89 yrs (52.61± 14.96yrs for women and 54.69 ± 12.80yrs for men, p= 0.34). Mean joint disease duration was 13.7 ± 8,92yrs. Cutaneous psoriasis preceded articular involvement in 53%, was concomitant in 38% and followed joint disease in 9%. Polyarticular subtype was the most common presentation accounting for 42% of PsA patients, while peripheral olygoarticular involvement occured in 20%, axial + peripheral polyarticular in 18%; pure axial disease in 12% and axial + peripheral olygoarticular in 8% of cases. According to drug therapy, 32 (20%) were under the action of anti-TNFagents, 94 (60%) were taking metothrexate, 18 (11%) leflunomide, 13 (8%) sulfasalazine, 5 (3%) other immunossupressors and 4 (2.5%) chloroquine; 85 (54%) were using NSAIDs and 21 (13%) were on low-dose prednisone. Over half patients (87patients, 55%) had arterial hypertension (AH) and 23% (36) had diabetes mellitus (DM). Statins were being used by 32% (51) cases. Lipid profile was similar for men and women revealing total cholesterol mean levels of 186.5±38.6mg/dl, LDL=112.3±30.6mg/dl, HDL= 47, 89 ± 14,6 and total triglycerides = 127.4±65.6mg/dl. Mean CRP levels was 9,13 ± 16,25. Remarkably, 14% (n=XX) PsA patients have had CVD, namely cerebrovascular or coronary heart disease. Sex, age, disease duration, joint involvement subtype, CRP and lipids levels were similar among patients with and without CVD. Notably, the prevalences of AH and DM were significantly higher (p<0.001) in the group of PsA patients who have had CVD, conferring an odds ratio of 5.44 for AH, of 3.27 for DM and of 8,32 for both.

Conclusion:

We have shown for the first time that despite psoriasis has recently been recognized as an independent CV risk factor, traditional risk factors such as AH and DM are important in the enhancement of the incidence of CVD in PsA patients. Therefore, early recognition and specific treatment of AH and/or DM is mandatory in order to prevent CVD in PsA patients

To cite this abstract, please use the following information:
Favarato, Maria Helena Sampaio, Saad, Carla Gonçalves, Goncalves, Célio Roberto, Sampaio-Barros, Percival Degrava, Goldenstein-Schainberg, Claudia; Hypertension and Diabetes Significantly Enhance the Risk for Cardiovascular Disease in Patients with Psoriasic Arthritis (PsA). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :531
DOI: 10.1002/art.28300

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