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Abstract
Introduction. Several studies reported an increased cardiovascular (CV) morbidity and mortality in patients with psoriatic arthritis (PsA). We performed a meta-analysis on the impact of PsA on major markers of CV risk.
Methods. Studies on the relationship between PsA and common carotid artery intima-media thickness (CCA-IMT), prevalence of carotid plaques, flow-mediated dilation (FMD), nitrate-mediated dilation (NMD), pulse wave velocity (PWV), augmentation index (AIx), and ankle-brachial index (ABI) were systematically searched in the PubMed, Web of Science, Scopus, and EMBASE databases.
Results. Sixteen case-control studies (898 cases, 1,140 controls) were included. Compared to controls, PsA patients showed a higher CCA-IMT (MD 0.07 mm; 95% CI 0.04, 0.11; P < 0.0001), and a higher frequency of carotid plaques (OR 3.12; 95% CI 1.03, 9.39; P = 0.04). Moreover, a lower FMD was found in PsA subjects than in controls (MD –2.56%; 95% CI –4.17, –0.94; P = 0.002), with no differences in NMD (MD –0.40%; 95% CI –1.19, 0.39; P = 0.32). Because of the low number of studies, no meta- analytical evaluation was performed for PWV, AIx, and ABI. Despite heterogeneity among studies, PsA appears significantly associated with markers of subclinical atherosclerosis and CV risk.
Discussion. These findings could help to establish more specific CV prevention strategies in this clinical setting.
Acknowledgements
The authors want to thank the members of the CaRRDs (Cardiovascular Risk in Rheumatic Diseases) study group: Matteo Nicola Dario Di Minno, Roberta Lupoli, Antonella Scalera, Alessandro Di Minno, Pasquale Ambrosino, Giovanni Tarantino, Giovanni Di Minno (Department of Clinical Medicine and Surgery, Regional Reference Centre for Coagulation Disorders, Federico II University, Naples, Italy); Rosario Peluso, Raffaele Scarpa (Department of Clinical Medicine and Surgery, Rheumatology Research Unit, Psoriatic Arthritis Clinic, Federico II University, Naples, Italy); Paolo Osvaldo Rubba (Department of Clinical Medicine and Surgery, Atherosclerosis Prevention and Vascular Medicine Unit, Federico II University, Naples, Italy); Salvatore Iervolino (Rheumatology and Rehabilitation Research Unit, ‘Salvatore Maugeri’ Foundation, Scientific Institute of Telese Terme, Benevento, Italy).
Funding: This study has been performed in the frame of the project entitled ‘Biomarkers of cardiovascular risk and disease activity in patients with psoriatic arthritis: modifications induced by treatment with TNF-alpha blockers’ [GR-2011-02352752] funded by the Italian Ministry of Health.
Declaration of interest: Matteo Nicola Dario Di Minno has acted as paid lecturer or board member and received grants and honoraria from Bayer, Biotest, Pfizer, and Novo-Nordisk in the last 36 months for researches unrelated to the present study. All the other authors have nothing to declare.
Supplementary material available online
Supplementary Appendix 1–3, to be found online at http://informahealthcare.com/doi/abs/10.3109/07853890.2015.1031822.