PsA confers higher risk of cardiovascular disease, events

Cardiovascular disease and major adverse cardiovascular events are significantly more common in patients with psoriatic arthritis (PsA) than in those without, according to two case-control studies involving individuals in the longitudinal, population-based United Kingdom Clinical Practice Research Datalink.

Dr. Lin Li and associates determined that the incidence of cardiovascular disease (CVD) in patients with PsA was 12.8 per 1,000 person-years, compared with 9.6 per 1,000 person-years in the non-PsA group, giving an incidence rate ratio (IRR) of 1.33. The investigators defined CVD as arrhythmias, ischemic heart disease, angina, myocardial infarction, stroke, pericardial disease, pulmonary hypertension, and sudden death, and only counted cases that had one of these diagnoses during the 1988-2012 study period.

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In a separate cohort from the U.K. database, the researchers selected individuals who had a major adverse cardiovascular event (MACE) – myocardial infarctions, strokes, and sudden deaths – since entering the cohort. The MACE incidence in the PsA group was 4.6 per 1,000 person-years and 3.5 per 1,000 person-years in the non-PsA group, yielding an IRR of 1.30.

Rates of CVD and MACE within the PsA group were higher in those who had received a prescription for systemic therapy. Patients who had taken corticosteroids had the highest rates of CVD and MACE, compared with those who had taken disease-modifying antirheumatic drugs, biologics, or immunosuppressants.

“The higher risk in treated patients with PsA compared to non-treated patients may be explained by the severity of the PsA disease: Patients who receive treatments are likely to have more severe disease than those who do not,” the investigators noted.

Find the full study in the Journal of Clinical Rheumatology (2015. doi: 10.1097/RHU.0000000000000306).

lfranki@frontlinemedcom.com