SAT0386 PREVALENCE OF SUBCLINICAL CARDIOVASCULAR DISEASE IN PSORIATIC ARTHRITIS: A MULTICENTRIC STUDY
Authors: Maria Paz Martínez-Vidal, José Andrés Lorenzo Martín, Mariano Andres, Vega Jovani, Carlos Santos Ramirez, Cintia Romera Lopez, Cristina Fernández-Carballido, Rubén Queiró Silva
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> There are scarce data regarding subclinical vascular disease in psoriatic arthritis (PsA)(1). Similarly to rheumatoid arthritis, the real CVR could also be underestimated by clinical risk charts (2). <h3>Objectives</h3> To study the prevalence of subclinical vascular atheromatosis in patients with PsA; to analyze the association of carotid plaques with PsA characteristics; to identify which patients with intermediate or high clinical risk would be worthwhile to undergo carotid ultrasound to detect plaque. <h3>Methods</h3> Descriptive, transversal and multicentric study, of patients with clinical diagnose of PsA followed in 4 Spanish hospitals. Demographic data, classic CVR factors and clinical characteristics were recorded. The probability of a 10 years fatal cardiovascular event was calculated by SCORE charts adapted for Spain (3), and afterwards a systematic bilateral common carotid ultrasound (4) was conducted. The intima-media thickness of the carotid wall and the presence of atheroma plaque were registered. Patient's characteristics were described using descriptive analysis techniques. For univariate comparisons we used Chi2 and Anova. Multivariate analyses were conducted by logistic regression. The probability of plaque according to the age and the presence of CVR factors was calculated for patients with clinical intermediate or high risk by means of logistic regression. The study was approved by the Hospital General Universitario de Elda Ethic Committee (RCV-PS-MC/26/02/2016). <h3>Results</h3> 309 patients were included. The characteristics of the sample and the prevalence of CVR factors are depicted in Table 1. Patients were stratified by SCORE as follows: low risk 41 patients (13.3%), intermediate 182 (58.9%), high 75 (24.3%) and very high 11 (3.6%) patients. Plaque criteria by ultrasound was found in 95 patients (30.7%), who were reclassified as very high risk. Final distribution after carotid ultrasound showed a decrease in all groups (12%, 43.7% and 14.2% in low, intermediate and high risk, respectively) with a consequent increase in the very high risk group (30.1%). In the univariate study, plaque was associated with age (p&lt;0.001), diabetes (p=0.004), hypertension (p=0.001), hyperuricemia (p=0.01) and dyslipidaemia (p&lt;0.001); any association with PsA characteristics wasn't found. In the multivariate analyses, plaque was associated with age &gt;55 years (OR 2.84; IC 1.54-5.55), and with the number of classical CVR factors (OR 1.49; IC 1.13-1.97). In the presence of 3 or more risk factors, the probability of having plaque was 57.2% in patients with clinical intermediate risk and 61.8% in patients with high risk, and raised with increasing presence of CVR factors (Table 2). <h3>Conclusion</h3> Subclinical vascular disease is present in almost a third of the patients with PsA. SCORE tables may prove inaccurate for estimating the real CVR, and carotid ultrasound would be advisable in patients with intermediate or high risk who present any classical CVR factor. <h3>Disclosure of Interests</h3> None declared