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.
The Prevalence of Cardiovascular Risk Factors in Patients with Early Psoriatic Arthritis.
MacDonald2, Don, Aslanov1, Rana, Khraishi3, Majed M.
Psoriatic Arthritis (PsA) is a chronic inflammatory disease affecting 535% of patients with psoriasis(PsO). Recently, both diseases were associated with an increased risk and a higher prevalence of cardiovascular (CVD) risk factors when compared to the general population.
To examine the prevalence of the risk factors of cardiovascular disease in patients with Early PsA (EPSA) and compare the prevalence of co-morbidities to those of established PsA patients.
The patients were recruited prospectively from a clinic specializing in treating patients with PsO and PsA. We set out to determine the prevalence of CVD risk factors including the Framingham Risk Score in the cohort of patients with early PsA of less than 2 years symptoms (EPSA cohort). Co-morbidities considered potential risk factors for cardiovascular disease (e.g. obesity, diabetes) were evaluated in the EPSA patients. Markers of inflammation and skin and joint disease severity and as risk factors for CVD were assessed by using CRP, ESR, DAS28, HAQ and PASI scores. The co-morbidities were compared to those of an established PsA cohort (more than 2 years of symptoms)
A total of 72 patients with Early PsA and 108 patients with Established PsA were included in this analysis. Females prevailed over males in EPSA cohort (58.3% vs. 41.7%) and their age at the onset of PSO (49.80 vs. 45.13) and PsA (50.42 vs. 44.65). Females were at higher risk for CVD in association with the Framingham Risk Category above 10% (58.3% vs. 32.0%). The prevalence of hypertension in EPSA was higher in males (50% vs. 38.5%; p=0.0329), while the prevalence of diabetes in EPsA was higher in females (30.8% vs. 18.8%; p=0.0025). Generally, the distribution of conventional risk factors was similar in both cohorts, except for obesity. From total number of 35 (50%) obese people in EPSA, 19 (54.3%) were females and 16 (45.7%) were males. Odds of being obese were 2.34 times higher for patients in EPSA compared to Established PsA (OR = 0.427; p = 0.0076). The prevalence of severe psoriasis was higher in patients with Established PsA (p = 0.0507); however, the expected PASI values were 1.52 units lower in patients in Established Cohort (p= 0.0001). Also, the ESR values in EPSA were significantly lower than those in Established PsA (p = 0.0008).Tthe utilization of NSAIDs, DMARDs and Biologics was significantly higher in Established PsA compared to EPsA (p= 0.0001), while the differences in using other medications remained non-significant.
These results support the hypothesis that PsA even at early stages may be associated with increased co-morbidities and cardiovascular risks. Obesity was more prevalent in patients with early arthritis, raising the possibility that the metabolic syndrome that is reported to be associated with established psoriasis is also present at the onset of arthritis (PsA). Longitudinal follow-up of these patients and analysis of their genetic background may help better understand the pathogenesis of these diseases. The PsA-specific risk factors reflected the disease activity, duration and severity, which suggest a need for a multidisciplinary approach so that patients can be identified and treated effectively.
To cite this abstract, please use the following information:
MacDonald, Don, Aslanov, Rana, Khraishi, Majed M.; The Prevalence of Cardiovascular Risk Factors in Patients with Early Psoriatic Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :554