Assessment of cardiovascular risk in patients with different forms of psoriasis and psoriatic arthritis

Introduction. Psoriasis and psoriatic arthritis are chronic immune-inflammatory diseases accompanied by a high frequency of cardiovascular comorbidity. Early diagnosis of subclinical atherosclerosis in young patients is of particular importance, when traditional risk stratification scales often underestimate its severity.

Aim. To assess the cardiovascular risk and prevalence of subclinical atherosclerosis in patients with various forms of psoriasis and psoriatic arthritis.

Materials and methods. The study included 106 patients divided into three groups: with pustular palmoplantar psoriasis (n = 31), with plaque psoriasis and psoriatic arthritis (n = 37), with plaque psoriasis without arthritis (n = 38). All patients underwent ultrasound duplex scanning of the brachiocephalic and peripheral arteries, lipid spectrum analysis and risk stratification according to the Framingham-30 scale. Statistical analysis included correlation and regression methods.

Results. Subclinical atherosclerosis was detected in 45.9% of patients with psoriatic arthritis, in 41.9% with pustular psoriasis and only in 23.7% with plaque psoriasis. At the same time, lesions of the arteries of the lower extremities prevailed over changes in the carotid arteries. Patients with pustular psoriasis had higher levels of total cholesterol and LDL, but the atherogenicity coefficient values did not differ between the groups. The Framingham-30 scale demonstrated high sensitivity but low specificity in predicting vascular changes.

Conclusions. In young patients with psoriatic arthritis and pustular psoriasis, the frequency of subclinical atherosclerosis is significantly higher than in isolated plaque psoriasis. The obtained data confirms the necessity to use instrumental methods for assessing vascular status along with traditional risk scales, which will allow for timely identification and correction of cardiovascular risk factors.

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