FRI0644 ANALYSIS OF CARDIOVASCULAR RISK AND CAROTID INTIMA-MEDIA THICKNESS IN PATIENTS WITH PSORIASIS
Authors: José Alexandre Mendonça, Elaine Cristina Faria Abrahão Machado, Luciana B. Nucci, Ana Carolina Belini Bázan Arruda
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Psoriasis (Ps) is associated with atherosclerosis and an increased risk of cardiovascular disease (CVR). Currently, a new automated ultrasound software, based on radio frequency, called QIMT (<i>quantitative intima media thickness)</i> technology, proved to be a useful method for assessing subclinical atherosclerosis with the measurement of the intima-media thickness (IMT) in carotid arteries<sup>1,2</sup>. <h3>Objectives</h3> To analyze the ultrasound results of the QIMT and Framingham score for psoriasis patients submitted to two types of treatments: methotrexate (MTX) and tumor necrosis factor inhibitor (TNF-α). <h3>Methods</h3> Fifty patients with psoriasis in plaques, were divided into two groups, using MTX and using TNF-α (infliximab and adalimumab). We evaluated the measurement of abdominal circumference, blood pressure, body mass index (BMI) and presence of metabolic syndrome (SM). In addition, we evaluated cardiovascular risk with the Framingham score and IMT of the two common carotid arteries using automatic software (QIMT) and laboratory tests, including fasting glycemia and total cholesterol, fractions and triglycerides. Data were analyzed using the t-student, chi-square test and the Mann-Whitney test. For the evaluation of the CVR, univariate and multivariate logistic regression analyzes were performed. The level of significance (α) adopted was 5%, being considered statistically significant values of p &lt;0.05. <h3>Results</h3> Total of 50 patients in the study, 25 were on MTX (group 1) and 25 were on anti-TNF-α (group 2). Mean age was 54.8 (± 12.5) with a slight male predominance (58%). Total cholesterol, HDL, LDL and triglycerides were altered in 50%, 76%, 30% and 42% of patients, respectively. Overall, 84% of the patients had high waist circumference and 82% had a BMI above the ideal. There was a statistically significant difference (p &lt;0.05) between the groups for metabolic syndrome results (68% vs. 32%); 44% of the patients in group 1 presented Framingham score intermediate to high and 28% of group 2, and in relation to the QIMT, 56% of group 1 and 72% of group 2 showed higher than expected (p&gt; 0.05). For the correlation between QIMT and Framingham Score, the Pearson (r) linear correlation coefficient found was 0.617 (p &lt;0.001), indicating a moderate to strong positive association. The cross-sectional analysis does not provide information on causality and the protective or non-protective effect of the aforementioned therapies in relation to cardiovascular risk was not evaluated. <h3>Conclusion</h3> The results show that patients with Ps have high rates of metabolic syndrome and subclinical atherosclerosis. There was a positive association correlating the Framingham score values with the QIMT measurement, providing evidence for the use of ultrasound in clinical practice. <h3>References</h3> [1]-Di Geso L, Zardi EM, Afeltra A, Salaffi F, Carotti M, Gutierrez M, et al. Comparison between conventional and automated software-guided ultrasound assessment of bilateral common carotids intima-media thickness in patients with rheumatic diseases. Clinical Rheumatolgy. 2012;31:881-884. [2] -Mendonça JA, Andrade BB, Aquino JLB, Leandro-Merhi VA, Damian GB. Spectral Doppler and automated software-guided ultrasound assessment of bilateral common carotid intima-media thickness in spondyloarthritis: is there a correlation with clinical findings? Drugs in Context. 2018;7:1-9. <h3>Disclosure of Interests</h3> None declared