Is Psoriatic Arthritis a Risk Factor for Vascular Disease?

JULY 27, 2016
Andrew Smith
New research comparing patients and controls suggests that the body’s inflammatory response to psoriatic arthritis can lead to atherosclerosis and then to cardiovascular disease.
 
Investigators examined 18 psoriatic arthritis patients and 18 age-and-sex-matched controls, looking for relationships (in both groups) between carotid intima-media thickness (CIMT) — which is a strong indicator of atherosclerosis — and numerous markers of inflammation and vascular function.
 
The inflammation markers included C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and several pro-inflammatory cytokines: interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-α. The markers of vascular function included lipids, intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), and endothelial progenitor cells (EPCs).
 
Compared with controls, psoriatic arthritis patients exhibited significantly higher CIMT (0.062 cm ± a standard deviation of 0.18 cm vs. 0.045 ± 0.10 cm; p < 0.01). They also expressed significantly higher levels of biomarkers related to inflammation: ESR, CRP, TNF-α, IL-6, ICAM-1, and VCAM-1.
 
Biomarkers related to good vascular function, on the other hand, were reduced in psoriatic arthritis patients. They had significantly lower flow mediated dilation (FMD) and endothelial progenitor cells (EPCs), as well as significantly less high-density lipoprotein (HDL) cholesterol (p < 0.05).
 
In psoriatic arthritis patients, CIMT positively correlated with IL-6 and ICAM-1 and inversely correlated with FMD, HDL, and EPCs (p < 0.05). What’s more, FMD and CIMT were both impaired in the psoriatic arthritis cohort, indicating endothelial dysfunction and accelerated atherosclerosis.
 


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