Psoriasis Linked to Greater Volume of Epicardial Adipose Tissue in Men

Epicardial adipose tissue volume was higher in men with psoriasis than those without, with no known prior coronary disease or diabetes, according to findings from a cross-sectional single-center study published in the Journal of the American Academy of Dermatology.

Investigators recruited adult dermatology patients with severe, chronic plaque psoriasis and control patients without psoriasis or any rheumatologic disease, either in themselves or in a first-degree relative, to undergo computed tomography (CT) imaging. Both groups of patients had no known history of coronary artery disease or diabetes mellitus. Investigators calculated epicardial adipose tissue volumes (EAT-V) from patients’ non-contrast CT heart images without knowing whether a patient had psoriasis. Investigators also obtained non-contrast coronary-calcium scores, and contrast-enhanced ECG-gated coronary CT angiography (CCTA) scans to determine the presence of plaque, degree of stenosis, and plaque composition.

There were 25 patients with psoriasis (14 men, 11 women) and 16 control participants (5 men, 11 women) included in the study. Both groups were similar in terms of mean age (range: 34-55 years), BMI, and various cardiovascular risk factors. High-sensitivity C-reactive protein (hs-CRP) was significantly higher in men with psoriasis compared with control participants (P =.03), but no difference was seen in women.

The mean EAT-V was higher in the psoriasis group compared with the control group (P =.04). Among the women, there was no statistically significant difference in EAT-V between the groups; however, men with psoriasis had significantly more EAT-V than control participants (P =.03), even when corrected for elevated hs-CRP (P =.05). There was no correlation between hsCRP or BMI and EAT-V in men. There was no significant difference between the groups regarding coronary-calcium scores or CCTA scans.

The study was limited by its single-center convenience sample of patients attending University of Michigan dermatology clinics, which may not represent the wider patient population.

Although psoriasis is a known risk factor for coronary artery disease, the pathogenesis is thought to be related to systemic inflammation, and the increased risk for subsequent cardiovascular events varies among studies. Therefore, “clinical evaluations that prognosticate risk of serious cardiovascular events for specific patients with psoriasis would have value,” the study authors wrote, noting that EAT-V “may be such a clinical assessment.”

Disclosure: Several study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Ellis CN, Neville SJ, Sayyouh M, et al. Epicardial adipose tissue volume is greater in men with severe psoriasis implying increased cardiovascular disease risk: A cross-sectional study. J Am Acad Dermatol. Published online October 19, 2021. doi:10.1016/j.jaad.2021.09.069