TOPLINE:
METHODOLOGY:
- Prior studies with small sample sizes have shown that CMD predicts poor cardiovascular outcomes in patients with severe psoriasis.
- In a prospective multicenter study, researchers enrolled 448 patients with moderate to severe psoriasis with no documented clinical cardiovascular disease who underwent transthoracic Doppler echocardiography to evaluate coronary microcirculation.
- The outcome variable of interest was CMD, defined as a coronary flow rate of 2.5 mL or less.
- The researchers used multivariable linear regression to model the associations of the characteristics of patients with psoriasis with CMD.
TAKEAWAY:
- Of the 448 patients, 141 (31.5%) showed CMD.
- Multivariable regression revealed four variables independently associated with CMD: higher Psoriasis Area Severity Index (PASI) score (per unit, odds ratio, 1.058; P < .001), duration of psoriasis (per year; OR, 1.046; P < .001), the presence of psoriatic arthritis (OR, 1.938; P = .015), and hypertension (OR, 2.169; P = .010).
- An increase of 1 point in the PASI score and 1 year of psoriasis duration were associated with a 5.8% and a 4.6% increased risk for CMD, respectively.
IN PRACTICE:
“We should diagnose and actively search for microvascular dysfunction in patients with psoriasis, as this population is at particularly high risk,” the researchers wrote.
SOURCE:
Stefano Piaserico, MD, PhD, of 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 were being treated for psoriasis, and other tools for assessing CMD were not used, such as PET-CT and cardiovascular MRI.
DISCLOSURES:
The authors reported having no relevant financial disclosures.
A version of this article first appeared on Medscape.com.