POS1402 HIGHER PREVALENCE OF SUBCLINICAL ATHEROSCLEROSIS IN PSORIATIC ARTHRITIS PATIENTS
Authors: S. Lugo-Perez, I. J. Colunga-Pedraza, D. Á. Galarza-Delgado, J. R. Azpiri-López, A. B. Rodriguez-Romero, N. Guajardo-Jauregui, D. E. Flores Alvarado, A. Cárdenas, A. C. Garza Acosta, O. Ilizaliturri Guerra, G. García-Arellano
Journal: Annals of the Rheumatic Diseases (2021)

Background: Psoriatic arthritis (PsA) patients have a higher risk of developing a cardiovascular (CV) event than the general population due to an increased prevalence of traditional CV risk factors and to disease characteristics such as disease duration and activity. The carotid ultrasound (US) is a non-invasive diagnostic tool that can detect the presence of subclinical atherosclerosis which is directly associated with the risk of developing a CV event. Objectives: The aim of this study is to compare the prevalence of subclinical atherosclerosis detected by carotid US in PsA patients and controls. Methods: This is a cross-sectional, observational, and comparative study. A total of seventy-five PsA patients aged 40-75 years old, who fulfilled the 2006 CASPAR criteria and seventy-five matched controls by age (±5 years), gender and comorbidities were recruited for this study. Patients with history of a previous CV event and pregnant women were excluded from this study. A high-resolution B mode carotid US was performed in all study subjects by a certified radiologist. Subclinical atherosclerosis was defined as the presence of a carotid plaque (CP) or an increased carotid intima media thickness (cIMT). The presence of CP was defined as a cIMT ≥1.2mm or a focal narrowing ≥0.5mm in the surrounding lumen. An increased cIMT was considered as a value ≥0.8mm. Distribution was evaluated with the Kolmogorov-Smirnov test. Comparisons were done with χ2 test for qualitative variables and Student´s t test and Mann-Whitney’s U test for quantitative variables. A p value &lt;0.05 was considered statistically significant. Results: There were no differences when comparing the demographic characteristics between both groups (Table 1). When comparing the carotid US findings, a statistically significant difference was found in the prevalence of CP, which was higher in the PsA group (44.0% vs 26.7%, p =0.026), in the presence of unilateral CP (25.3% vs 10.7%, p =0.019) and in the presence of subclinical atherosclerosis (52.0% vs 34.7%, p =0.032) (Figure 1). Conclusion: The prevalence of subclinical atherosclerosis was higher in PsA patients than controls, and this could be attributed to an increase in the inflammatory burden of these patients. The carotid US should be considered as part of the CV evaluation in all PsA patients, identifying those who would benefit from an opportune treatment preventing the development of a CV event. References: [1]Yim KM, Armstrong AW. Updates on cardiovascular comorbidities associated with psoriatic diseases: epidemiology and mechanisms. Rheumatol Int. 2017;37(1):97–105. Table 1. Demographic and clinical characteristics of psoriatic arthritis patients and controls. PsA (n=75 ) Controls (n=75 ) p Age years, mean ± DE 53.89 ± 10.59 54.25 ± 7.08 NS Female gender, n (%) 43 (57.3) 43 (57.3) NS T2DM, n (%) 16 (21.3) 15 (20.0) NS HTN, n (%) 28 (37.3) 21 (28.0) NS Dyslipidemia, n (%) 33 (44.0) 28 (37.3) NS Obesity, n (%) 31 (41.3) 32 (42.7) NS Active smoking, n (%) 14 (18.7) 18 (24.0) NS BMI kg/m 2 , median (p25-p75) 29.32 (26.23-32.03) 28.9 (25.4-33.5) NS Disease duration years, median (p25-p75) 5.0 (3.0-10.0) - - DAPSA, median (p25-p75) 12.6 (5.3-22.9) - - Glucocorticoids, n (%) 10 (13.3) - - MTX, n (%) 51 (68.0) - - bDMARD, n (%) 28 (37.3) - - PsA, psoriatic arthritis; NS, not significant; T2DM, type 2 diabetes mellitus; HTN, hypertension; BMI, body mass index; DAPSA, disease activity for psoriatic arthritis; MTX, methotrexate; bDMARD, biological disease modifying antirheumatic drug. Disclosure of Interests: None declared