Coronary blood flow capacity as measured by total coronary artery blood volume in relation to myocardial mass (V/M) is reduced in patients with psoriasis, according to study findings published in the Journal of Investigative Dermatology.
The longitudinal cohort study included 214 consecutive patients with psoriasis (mean age 50.6 ± 12.4; 62% men) who were recruited from January 1, 2013, through November 1, 2019, in the Psoriasis Atherosclerosis Cardiometabolic Initiative. In addition, 20 healthy volunteers (mean age 44.8 ± 12.4; 75% men) were recruited from the same center to serve as the comparator group. The 2 cohorts had a similar prevalence of traditional risk factors and low cardiovascular risk according to Framingham risk score.
Psoriasis skin disease severity as assessed with the Psoriasis Area and Severity Index (PASI) score was significantly associated with low V/M (adjusted odds ratio [OR] 1.55 [1.05-2.29], P = .026). This relationship remained after adjustment for baseline use of systemic therapy (adjusted OR 1.51 [1.01-2.27], P = .047).
Increases in total coronary artery disease burden in psoriasis were also associated with low V/M (adjusted OR 3.02 [1.72–5.31], P < .0001], which was primarily driven by the relationship between noncalcified coronary burden (NCB) and V/M (adjusted OR 3.04 [1.79-5.14], P < .0001).
“Interestingly, skin disease severity as assessed by PASI score remained associated with low V/M even when further adjusted for NCB (adjusted OR 1.50 [1.01-2.24], P = .042),” noted the researchers.
“We found that coronary blood flow capacity as measured by V/M was reduced in psoriasis and that as psoriasis severity increased, V/M reduced beyond traditional risk factors, suggesting impaired coronary blood flow in psoriasis,” stated the study authors. “Our observed differences in V/M in our psoriasis patients are in line with prior findings in coronary artery disease patients and may be in part due to impaired endothelial function seen in psoriasis patients.”
Study limitations include the cross-sectional design, the lack of hard cardiovascular events as end points, and the control cohort was not perfectly matched to the psoriasis cohort.
“We provide important consequences of early coronary artery disease on coronary blood flow, which may aid in addressing the increased risk of cardiovascular disease in psoriasis,” the researchers commented.
Disclosures: Several of the authors reported affiliations with the pharmaceutical industry. Please see the original reference for a full list of disclosures.
Uceda DE, Dey AK, Lateef SS, et al. Impaired coronary blood flow in patients with psoriasis: Findings from an observational cohort study [published online September 30, 2020]. J Invest Dermatol. doi: https://doi.org/10.1016/j.jid.2020.07.037