Patients with Psoriatic Arthritis are at Increased Risk of Cardiovascular Disease

Google+ Interview with:

Lihi Eder, MD, PhD Assistant Professor of Medicine, University of Toronto Scientist, Women’s College Research Institute,Room 6326 Women’s College Hospital Toronto, ON, Canada

Dr. Lihi Eder

Lihi Eder, MD, PhD
Assistant Professor of Medicine
University of Toronto
Scientist, Women’s College Research Institute,Room  6326
Women’s College Hospital
Toronto, ON, Canada What is the background for this study?

Dr. Eder: Psoriasis is a chronic immune-mediated skin disease affecting 2-3% of the general population. Psoriatic arthritis (PsA) affects 15-30% of patients with psoriasis. Until recently, only few studies assessed the risk of developing cardiovascular events in patients with PsA and while most studies found a higher cardiovascular risk in these patients, others reported cardiovascular rates that were similar to the general population. What are the main findings?

Dr. Eder: To address this gap in knowledge, we performed a systematic review and meta-analysis of observational studies to estimate the magnitude of the risk of incident and prevalent cardiovascular and cerebrovascular diseases in patients with Psoriatic arthritis compared with the general population.

We analyzed 11 studies comprising over 30,000 patients with PsA. We found a 43% increased risk of cardiovascular diseases in patients with Psoriatic arthritis compared with the general population. The risk of incident cardiovascular events was increased by 55%. Morbidity risks for myocardial infarction, cerebrovascular diseases and heart failure were increased by 68%, 22% and 31%, respectively. What should clinicians and patients take away from your report?

Dr. Eder: The study establishes the association between Psoriatic arthritis and cardiovascular diseases. Patients with PsA, similarly to patients with psoriasis and to those with rheumatoid arthritis, are at increased risk of developing cardiovascular events. High cardiovascular risk was observed in all cardiac outcomes, in particular with myocardial infarction. These findings suggest that patients with PsA should be carefully screened and managed for traditional cardiovascular risk factors such as abnormal lipids, hypertension and diabetes to reduce their chances of developing these events. What recommendations do you have for future research as a result of this study?

Dr. Eder: The underlying mechanisms associated with the increased cardiovascular risk in Psoriatic arthritis are unclear. It is likely that the interaction between chronic inflammation related to the skin and the joints as well as the high prevalence of obesity and its related metabolic abnormalities in PsA increases cardiovascular risk. Future research may focus on investigating these mechanisms and address the question whether suppression of inflammation could reduce cardiovascular risk in Psoriatic arthritis. Thank you for your contribution to the community.


Risk of cardiovascular morbidity in patients with psoriatic arthritis: A meta-analysis of observational studies

Ari Polachek MD Clinical and Research Fellow, Zahi Touma MD, PhD Assistant Professor of Medicine, Melanie Anderson MLIS Library and Information Services and Lihi Eder MD, PhD Assistant Professor of Medicine4,*

DOI: 10.1002/acr.22926
Arthritis Care and Research

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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