AB0851 CAROTID ULTRASOUND IN PSORIATIC ARTHRITIS: A CASE-CONTROL STUDY
Authors: D. Á. Galarza-Delgado, J. R. Azpiri-López, I. J. Colunga-Pedraza, D. E. Flores Alvarado, O. Ilizaliturri Guerra, I. C. Zárate Salinas, P. F. Frausto Lerma, A. Pérez Villar, M. A. Reyes Soto, A. C. Garza Acosta
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patients with psoriatic arthritis (PsA) have an increased risk of cardiovascular disease (CVD). The carotid ultrasound, which measures both carotid intima-media thickness (cIMT) and carotid plaque (CP), is a non-invasive tool useful in the detection of subclinical atherosclerosis 1 . However, carotid ultrasound differences between PsA patients and general population have not yet been well described. Objectives: This study aimed to compare the carotid ultrasound characteristics in PsA patients with controls. Methods: This cross-sectional study included 70 PsA patients that fulfilled the CASPAR (Classification Criteria for Psoriatic Arthritis) criteria and 70 controls subjects matched by age and comorbidities. Patients with a history of previous atherosclerotic CVD (ischemic heart disease, cerebrovascular accident or peripheral arterial disease) and pregnancy were excluded. A clinical history and blood tests were performed. Carotid B-mode ultrasonography was used for measurements of cIMT and the presence of plaques. Increased cIMT was defined as ≥0.9 mm to 1.1 mm. CP was defined as a focal narrowing ≥0.5 mm of the surrounding lumen or a cIMT ≥1.2 mm. Descriptive analysis was done with frequencies (%), mean (±SD) and median (q25-q75), and comparisons with Chi square, Student´s t and Mann-Whitney U tests. Results: A total of 138 subjects were included. Clinical and demographic characteristics are shown in Table 1. Increased cIMT and right carotid plaque were significantly more prevalent in PsA patients compared to controls (p= 0.017 and p=0.049, respectively). No significant differences were found in the prevalence of carotid plaque and in the intima-media thickness between the PsA patients and the control group. Table 1. Clinical and demographic characteristics. Variable PsA (n=69) Controls (n=69) P Age(mean±SD) 53.58±10.946 53.86±7.313 NS Women, n (%) 38(55.1) 59(85.5) &lt;0.001 Obese, n (%) 26(37.7) 28(40.6) NS Type 2 Diabetes, n (%) 14(20.3) 9(13) NS Hypertension, n (%) 27(39.1) 19(27.5) NS Dyslipidemia, n (%) 29(42) 24(34.8) NS Active smoker, n(%) 15(21.7) 12(17.4) NS Disease duration, median (q25-q75) 5(2.5-8) - - Methotrexate, n (%) 46(66.7) - - Biologics, n (%) 23(33.3) - - DAS28-ESR, (mean±SD) 3.74±1.477 - - DAS28-CRP, (mean±SD) 2.43±1.088 - - DAPSA, median (q25-q75) 35(27.5-58.5) - - Conclusion: Patients with psoriatic arthritis have a higher cardiovascular risk, as proven by the increased cIMT found on carotid ultrasound results. Therefore, it is advisable to perform a carotid ultrasound in patients with PsA to achieve an optimal management of the disease. The rheumatologist must be aware of the importance of performing a complete cardiovascular evaluation to provide a correct treatment in order to lower possible cardiac events. References: [1]Lucke, M., Messner, W., Kim, E.S.H. et al. The impact of identifying carotid plaque on addressing cardiovascular risk in psoriatic arthritis. Arthritis Research &amp; Therapy 18, 178 (2016). https://doi.org/10.1186/s13075-016-1074-2 Table 2. Carotid ultrasound findings. Variable PsA (n=69) Controls (n=69) P Any carotid plaque, n (%) 27(39.1) 17(24.6) NS Right carotid plaque, n (%) 18(26.1) 8(11.6) 0.049 Left carotid plaque, n (%) 19(27.5) 15(21.7) NS Increased cIMT, n (%) 9(13) 1(1.4) 0.017 Right cIMT, median (q25-q75) 0.58(0.46-0.76) 0.6(0.51-0.69) NS Left cIMT, median (q25-q75) 0.58(0.5-0.73) 0.61(0.54-0.78) NS Disclosure of Interests: None declared