Coronary Microvascular Dysfunction in Asymptomatic Patients with Severe Psoriasis

银屑病 医学 内科学 心脏病学 无症状的 人口 银屑病性关节炎 队列 皮肤病科 环境卫生
作者
Stefano Piaserico,Evangelia Papadavid,Annagrazia Cecere,Gloria Orlando,Konstantinos Theodoropoulos,Pelagia Katsimbri,George Makavos,Pinelopi Rafouli‐Stergiou,Sabino Iliceto,Mauro Alaibac,Francesco Tona,Ignatios Ikonomidis
出处
期刊:Journal of Investigative Dermatology [Elsevier]
卷期号:143 (10): 1929-1936.e2 被引量:5
标识
DOI:10.1016/j.jid.2023.02.037
摘要

Severe psoriasis is associated with an increased cardiovascular risk, which may be independent of the traditional risk factors. Coronary microvascular dysfunction (CMD) has been shown to predict a poor cardiovascular prognosis in the general population and in patients with psoriasis. In this study, we assessed the prevalence and predictors of CMD in a large cohort of patients with psoriasis without clinical cardiovascular disease. A total of 503 patients with psoriasis were enrolled and underwent transthoracic Doppler echocardiography to evaluate coronary microcirculation. Of these, 55 patients were excluded from the analyses because of missing data. Of the 448 patients in this study, 31.5% showed CMD. Higher PASI, longer disease duration, the presence of psoriatic arthritis, and hypertension were independently associated with CMD. An increase of 1 point of PASI and 1 year of psoriasis duration were associated with a 5.8% and 4.6% increased risk of CMD, respectively. In our study, CMD was associated with the severity and duration of psoriasis. This supports the role of systemic inflammation in CMD and suggests that the coronary microcirculation may represent an extracutaneous site involved in the immune-mediated injury of psoriasis. We should diagnose and actively search for CMD in patients with severe psoriasis.
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