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Summary:
A substantial cross-sectional study found that nearly one third of severe psoriasis patients exhibited signs of coronary microvascular dysfunction (CMD), which is linked to poor cardiovascular outcomes.
Methodology:
Researchers conducted a prospective multi-center study with 448 patients having moderate to severe psoriasis without documented clinical cardiovascular disease. They underwent transthoracic Doppler echocardiography to assess coronary microcirculation. CMD was defined as a coronary flow rate ≤ 2.5 mL. Multivariable linear regression was employed to analyze associations between patient characteristics and CMD.
Key Findings:
Out of the 448 patients, 141 (31.5%) displayed CMD. Variables independently associated with CMD were higher psoriasis area severity index (PASI) score (per unit, odds ratio [OR], 1.058; P < .001), duration of psoriasis (per year; OR, 1.046; P < .001), presence of psoriatic arthritis (OR, 1.938; P = .015), and hypertension (OR, 2.169; P = .010). A one-point increase in PASI score and one year longer psoriasis duration correlated with a 5.8% and 4.6% higher risk for CMD, respectively.
Clinical Implications:
The researchers suggest actively diagnosing and investigating microvascular dysfunction in psoriasis patients, given their heightened risk.
Source:
Dr. Stefano Piaserico from the University of Padova, Italy, led the research. The study was published in the Journal of Investigative Dermatology.
Limitations:
A small proportion of patients in the study received treatment for psoriasis. Additional tools like PET-CT and cardiovascular MRI for CMD assessment were not utilized.
Disclosures:
The authors reported no relevant financial disclosures.
