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J Am Acad Dermatol. 2017 Oct;77(4):650-656.e3. doi: 10.1016/j.jaad.2017.06.028. Epub 2017 Aug 18.

The relationship between duration of psoriasis, vascular inflammation, and cardiovascular events.

Author information

1
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Electronic address: alexander.egeberg@gmail.com.
2
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
3
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
4
Unit of Dermatology and Venerology, Karolinska Institutet, Stockholm, Sweden.
5
Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Danish Heart Foundation, Copenhagen, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
6
Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.
7
Department of Dermatology, Department of Biostatistics and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.
8
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: nehal.mehta@nih.gov.

Abstract

BACKGROUND:

Psoriasis is associated with risk of cardiovascular (CV) disease (CVD) and a major adverse CV event (MACE). Whether psoriasis duration affects risk of vascular inflammation and MACEs has not been well characterized.

OBJECTIVES:

We utilized two resources to understand the effect of psoriasis duration on vascular disease and CV events: (1) a human imaging study and (2) a population-based study of CVD events.

METHODS:

First, patients with psoriasis (N = 190) underwent fludeoxyglucose F 18 positron emission tomography/computed tomography (duration effect reported as a β-coefficient). Second, MACE risk was examined by using nationwide registries (adjusted hazard ratios in patients with psoriasis (n = 87,161) versus the general population (n = 4,234,793).

RESULTS:

In the human imaging study, patients were young, of low CV risk by traditional risk scores, and had a high prevalence of cardiometabolic diseases. Vascular inflammation by fludeoxyglucose F 18 positron emission tomography/computed tomography was significantly associated with disease duration (β = 0.171, P = .002). In the population-based study, psoriasis duration had strong relationship with MACE risk (1.0% per additional year of psoriasis duration [hazard ratio, 1.010; 95% confidence interval, 1.007-1.013]).

LIMITATIONS:

These studies utilized observational data.

CONCLUSION:

We found detrimental effects of psoriasis duration on vascular inflammation and MACE, suggesting that cumulative duration of exposure to low-grade chronic inflammation may accelerate vascular disease development and MACEs. Providers should consider inquiring about duration of disease to counsel for heightened CVD risk in psoriasis.

KEYWORDS:

18-FDG PET/CT; cardiovascular disease; inflammation; psoriasis

PMID:
28826925
PMCID:
PMC5657544
DOI:
10.1016/j.jaad.2017.06.028
[Indexed for MEDLINE]
Free PMC Article

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