Cardiovascular risk in patients with psoriatic arthritis

Abstract

Psoriatic arthritis (PsA) is a chronic immune-mediated disease that is observed in 8-30% of psoriatic patients. It has been recently established that PsA and psoriasis are closely associated with the high prevalence of metabolic syndrome, hypertension, abdominal obesity, and a risk for cardiovascular diseases (CVD), including fatal myocardial infarction (MI) and acute cerebrovascular accidents, which shortens lifespan in the patients compared to the general population. The authors state their belief that the synergic effect of traditional risk factors (RFs) for CVD and systemic inflammation underlie the development of atherosclerosis in PsA. It is pointed out that the risk of CVD may be reduced not only provided that the traditional RFs for CVD are monitored, but also systemic inflammation is validly suppressed. The cardioprotective abilities of methotrexate and tumor necrosis factor-α (TNF-α) inhibitors are considered; the data of investigations showing that the treatment of PsA patients with TNF-α inhibitors results in a reduction in carotid artery intima-media thickness are given. It is noted that there is a need for the early monitoring of traditional RFs for CVD in patients with PsA and for the elaboration of interdisciplinary national guidelines.

Keywords

• psoriatic arthritis
• cardiovascular diseases
• atherosclerosis
• methotrexate
• cardiovascular risk