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01-03-2020 | Vulgar Psoriasis | Comorbidities

Prevalence of high-sensitivity cardiac troponin T in real-life cohorts of psoriatic arthritis and general population: a cross-sectional study

Authors: Victoria Furer, Shani Shenhar-Tsarfaty, Shlomo Berliner, Uri Arad, Daphna Paran, Inna Mailis, Ori Rogowski, David Zeltser, Itzhak Shapira, Hagit Matz, Ori Elkayam

Published in: Rheumatology International | Issue 3/2020

Abstract

Patients with psoriatic arthritis (PsA) are at increased risk of cardiovascular disease (CVD). High-sensitivity cardiac troponin T (hs-cTnT) is a novel biomarker of CVD. The objective of this study is to determine the prevalence of circulating hs-cTnT in patients with PsA compared to the general population and to characterize a PsA subset with detectable hs-cTnT. A cross-sectional analysis of serum hs-cTnT levels was performed in 116 consecutive patients with PsA and the Tel-Aviv Medical Center Inflammatory Survey cohort of the general population (n = 6052) as a control group. The level and prevalence of hs-cTnT (ng/L) were similar in the entire study population: 4.94 ± 4.4, 30.2% in PsA, 5.17 ± 6.7, 34.2% and 5.38 ± 4.3, 37.9% in unmatched and matched control groups according to age, gender and cardiovascular risk factors, respectively. Factors associated with detectable hs-cTnT in PsA included male gender (p = 0.002), age (p = 0.007), hypertension (p < 0.001), diabetes mellitus (p < 0.001), and smoking (p = 0.001). Axial disease, present in 25% of patients with PsA, was significantly associated with detectable hs-cTnT (p = 0.004). This association remained significant after adjusting for age, gender and traditional cardiovascular risk factors. No correlation between hs-cTnT levels and disease characteristics, PsA activity indices, C-reactive protein levels, or treatments for PsA was found. In summary, serum hs-cTnT was detectable in about the third of the PsA and control cohorts. In PsA, axial disease was significantly associated with detectable hs-TnT, warranting a particular attention to cardiovascular risk assessment in this sub-group. The role of hs-cTnT as a biomarker for CVD in PsA should be further investigated in prospective studies.

Jamnitski A, Symmons D, Peters MJ, Sattar N, McInnes I, Nurmohamed MT (2013) Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. Ann Rheum Dis 72(2):211–216. https://doi.org/10.1136/annrheumdis-2011-201194 CrossRefPubMed

Ogdie A, Yu Y, Haynes K, Love TJ, Maliha S, Jiang Y, Troxel AB, Hennessy S, Kimmel SE, Margolis DJ, Choi H, Mehta NN, Gelfand JM (2015) Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis 74(2):326–332. https://doi.org/10.1136/annrheumdis-2014-205675 CrossRefPubMed

Polachek A, Touma Z, Anderson M, Eder L (2017) Risk of cardiovascular morbidity in patients with psoriatic arthritis: a meta-analysis of observational studies. Arthritis Care Res (Hoboken) 69(1):67–74. https://doi.org/10.1002/acr.22926 CrossRef

Schieir O, Tosevski C, Glazier RH, Hogg-Johnson S, Badley EM (2017) Incident myocardial infarction associated with major types of arthritis in the general population: a systematic review and meta-analysis. Ann Rheum Dis 76(8):1396–1404. https://doi.org/10.1136/annrheumdis-2016-210275 CrossRefPubMed

Shen J, Wong KT, Cheng IT, Shang Q, Li EK, Wong P, Kun EW, Law MY, Yip R, Yim I, Ying S, Li M, Li TK, Wong CK, Zhu TY, Lee JJ, Chang M, Lee AP, Tam LS (2017) Increased prevalence of coronary plaque in patients with psoriatic arthritis without prior diagnosis of coronary artery disease. Ann Rheum Dis 76(7):1237–1244. https://doi.org/10.1136/annrheumdis-2016-210390 CrossRefPubMed

Jafri K, Bartels CM, Shin D, Gelfand JM, Ogdie A (2017) Incidence and management of cardiovascular risk factors in psoriatic arthritis and rheumatoid arthritis: a population-based study. Arthritis Care Res (Hoboken) 69(1):51–57. https://doi.org/10.1002/acr.23094 CrossRef

Ogdie A, Schwartzman S, Husni ME (2015) Recognizing and managing comorbidities in psoriatic arthritis. Curr Opin Rheumatol 27(2):118–126. https://doi.org/10.1097/bor.0000000000000152 CrossRefPubMed

Shah K, Paris M, Mellars L, Changolkar A, Mease PJ (2017) Real-world burden of comorbidities in US patients with psoriatic arthritis. RMD Open 3(2):e000588. https://doi.org/10.1136/rmdopen-2017-000588 CrossRefPubMedPubMedCentral

Abdolmaleki F, Gheibi Hayat SM, Bianconi V, Johnston TP, Sahebkar A (2018) Atherosclerosis and immunity: a perspective. Trends Cardiovasc Med. https://doi.org/10.1016/j.tcm.2018.09.017 CrossRefPubMed

10.

Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJ, Kvien TK, Dougados M, Radner H, Atzeni F, Primdahl J, Sodergren A, Wallberg Jonsson S, van Rompay J, Zabalan C, Pedersen TR, Jacobsson L, de Vlam K, Gonzalez-Gay MA, Semb AG, Kitas GD, Smulders YM, Szekanecz Z, Sattar N, Symmons DP, Nurmohamed MT (2017) EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis 76(1):17–28. https://doi.org/10.1136/annrheumdis-2016-209775 CrossRefPubMed

11.

Crowson CS, Matteson EL, Roger VL, Therneau TM, Gabriel SE (2012) Usefulness of risk scores to estimate the risk of cardiovascular disease in patients with rheumatoid arthritis. Am J Cardiol 110(3):420–424. https://doi.org/10.1016/j.amjcard.2012.03.044 CrossRefPubMedPubMedCentral

12.

Ernste FC, Sanchez-Menendez M, Wilton KM, Crowson CS, Matteson EL, Maradit Kremers H (2015) Cardiovascular risk profile at the onset of psoriatic arthritis: a population-based cohort study. Arthritis Care Res (Hoboken) 67(7):1015–1021. https://doi.org/10.1002/acr.22536 CrossRef

13.

D’Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB (2008) General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 117(6):743–753. https://doi.org/10.1161/CIRCULATIONAHA.107.699579 CrossRefPubMed

14.

Park KC, Gaze DC, Collinson PO, Marber MS (2017) Cardiac troponins: from myocardial infarction to chronic disease. Cardiovasc Res 113(14):1708–1718. https://doi.org/10.1093/cvr/cvx183 CrossRefPubMedPubMedCentral

15.

Saunders JT, Nambi V, de Lemos JA, Chambless LE, Virani SS, Boerwinkle E, Hoogeveen RC, Liu X, Astor BC, Mosley TH, Folsom AR, Heiss G, Coresh J, Ballantyne CM (2011) Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the Atherosclerosis Risk in Communities Study. Circulation 123(13):1367–1376. https://doi.org/10.1161/CIRCULATIONAHA.110.005264 CrossRefPubMedPubMedCentral

16.

de Lemos JA, Drazner MH, Omland T, Ayers CR, Khera A, Rohatgi A, Hashim I, Berry JD, Das SR, Morrow DA, McGuire DK (2010) Association of troponin T detected with a highly sensitive assay and cardiac structure and mortality risk in the general population. JAMA 304(22):2503–2512. https://doi.org/10.1001/jama.2010.1768 CrossRefPubMedPubMedCentral

17.

Willeit P, Welsh P, Evans JDW, Tschiderer L, Boachie C, Jukema JW, Ford I, Trompet S, Stott DJ, Kearney PM, Mooijaart SP, Kiechl S, Di Angelantonio E, Sattar N (2017) High-sensitivity cardiac troponin concentration and risk of first-ever cardiovascular outcomes in 154,052 participants. J Am Coll Cardiol 70(5):558–568. https://doi.org/10.1016/j.jacc.2017.05.062 CrossRefPubMedPubMedCentral

18.

Divard G, Abbas R, Chenevier-Gobeaux C, Chanson N, Escoubet B, Chauveheid MP, Dossier A, Papo T, Dehoux M, Sacre K (2017) High-sensitivity cardiac troponin T is a biomarker for atherosclerosis in systemic lupus erythematous patients: a cross-sectional controlled study. Arthritis Res Ther 19(1):132. https://doi.org/10.1186/s13075-017-1352-7 CrossRefPubMedPubMedCentral

19.

Avouac J, Meune C, Chenevier-Gobeaux C, Borderie D, Lefevre G, Kahan A, Allanore Y (2015) Cardiac biomarkers in systemic sclerosis: contribution of high-sensitivity cardiac troponin in addition to N-terminal pro-brain natriuretic peptide. Arthritis Care Res (Hoboken) 67(7):1022–1030. https://doi.org/10.1002/acr.22547 CrossRef

20.

Bradham WS, Bian A, Oeser A, Gebretsadik T, Shintani A, Solus J, Estis J, Lu QA, Todd J, Raggi P, Stein CM (2012) High-sensitivity cardiac troponin-I is elevated in patients with rheumatoid arthritis, independent of cardiovascular risk factors and inflammation. PLoS One 7(6):e38930. https://doi.org/10.1371/journal.pone.0038930 CrossRefPubMedPubMedCentral

21.

Karpouzas GA, Estis J, Rezaeian P, Todd J, Budoff MJ (2018) High-sensitivity cardiac troponin I is a biomarker for occult coronary plaque burden and cardiovascular events in patients with rheumatoid arthritis. Rheumatology (Oxford) 57(6):1080–1088. https://doi.org/10.1093/rheumatology/key057 CrossRef

22.

Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H, Group CS (2006) Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 54(8):2665–2673. https://doi.org/10.1002/art.21972 CrossRefPubMed

23.

Schoels M, Aletaha D, Funovits J, Kavanaugh A, Baker D, Smolen JS (2010) Application of the DAREA/DAPSA score for assessment of disease activity in psoriatic arthritis. Ann Rheum Dis 69(8):1441–1447. https://doi.org/10.1136/ard.2009.122259 CrossRefPubMed

24.

Aletaha D, Alasti F, Smolen JS (2017) Disease activity states of the DAPSA, a psoriatic arthritis specific instrument, are valid against functional status and structural progression. Ann Rheum Dis 76(2):418–421. https://doi.org/10.1136/annrheumdis-2016-209511 CrossRefPubMed

25.

van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 27(4):361–368CrossRef

26.

Lambert RG, Bakker PA, van der Heijde D, Weber U, Rudwaleit M, Hermann KG, Sieper J, Baraliakos X, Bennett A, Braun J, Burgos-Vargas R, Dougados M, Pedersen SJ, Jurik AG, Maksymowych WP, Marzo-Ortega H, Ostergaard M, Poddubnyy D, Reijnierse M, van den Bosch F, van der Horst-Bruinsma I, Landewe R (2016) Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group. Ann Rheum Dis 75(11):1958–1963. https://doi.org/10.1136/annrheumdis-2015-208642 CrossRefPubMed

27.

Fredriksson T, Pettersson U (1978) Severe psoriasis–oral therapy with a new retinoid. Dermatologica 157(4):238–244CrossRef

28.

Agarwal SK, Avery CL, Ballantyne CM, Catellier D, Nambi V, Saunders J, Sharrett AR, Coresh J, Heiss G, Hoogeveen RC (2011) Sources of variability in measurements of cardiac troponin T in a community-based sample: the atherosclerosis risk in communities study. Clin Chem 57(6):891–897. https://doi.org/10.1373/clinchem.2010.159350 CrossRefPubMedPubMedCentral

29.

McEvoy JW, Chen Y, Ndumele CE, Solomon SD, Nambi V, Ballantyne CM, Blumenthal RS, Coresh J, Selvin E (2016) Six-year change in high-sensitivity cardiac troponin T and risk of subsequent coronary heart disease, heart failure, and death. JAMA Cardiol 1(5):519–528. https://doi.org/10.1001/jamacardio.2016.0765 CrossRefPubMedPubMedCentral

30.

Giannitsis E, Kurz K, Hallermayer K, Jarausch J, Jaffe AS, Katus HA (2010) Analytical validation of a high-sensitivity cardiac troponin T assay. Clin Chem 56(2):254–261. https://doi.org/10.1373/clinchem.2009.132654 CrossRefPubMed

31.

Apple FS, Ler R, Murakami MM (2012) Determination of 19 cardiac troponin I and T assay 99th percentile values from a common presumably healthy population. Clin Chem 58(11):1574–1581. https://doi.org/10.1373/clinchem.2012.192716 CrossRefPubMed

32.

Emerging Risk Factors C, Kaptoge S, Di Angelantonio E, Pennells L, Wood AM, White IR, Gao P, Walker M, Thompson A, Sarwar N, Caslake M, Butterworth AS, Amouyel P, Assmann G, Bakker SJ, Barr EL, Barrett-Connor E, Benjamin EJ, Bjorkelund C, Brenner H, Brunner E, Clarke R, Cooper JA, Cremer P, Cushman M, Dagenais GR, D’Agostino RB Sr, Dankner R, Davey-Smith G, Deeg D, Dekker JM, Engstrom G, Folsom AR, Fowkes FG, Gallacher J, Gaziano JM, Giampaoli S, Gillum RF, Hofman A, Howard BV, Ingelsson E, Iso H, Jorgensen T, Kiechl S, Kitamura A, Kiyohara Y, Koenig W, Kromhout D, Kuller LH, Lawlor DA, Meade TW, Nissinen A, Nordestgaard BG, Onat A, Panagiotakos DB, Psaty BM, Rodriguez B, Rosengren A, Salomaa V, Kauhanen J, Salonen JT, Shaffer JA, Shea S, Ford I, Stehouwer CD, Strandberg TE, Tipping RW, Tosetto A, Wassertheil-Smoller S, Wennberg P, Westendorp RG, Whincup PH, Wilhelmsen L, Woodward M, Lowe GD, Wareham NJ, Khaw KT, Sattar N, Packard CJ, Gudnason V, Ridker PM, Pepys MB, Thompson SG, Danesh J (2012) C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med 367(14):1310–1320. https://doi.org/10.1056/NEJMoa1107477 CrossRef

33.

Roubille C, Richer V, Starnino T, McCourt C, McFarlane A, Fleming P, Siu S, Kraft J, Lynde C, Pope J, Gulliver W, Keeling S, Dutz J, Bessette L, Bissonnette R, Haraoui B (2015) The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis 74(3):480–489. https://doi.org/10.1136/annrheumdis-2014-206624 CrossRefPubMedPubMedCentral

34.

Eder L, Joshi AA, Dey AK, Cook R, Siegel EL, Gladman DD, Mehta NN (2018) Association of tumor necrosis factor inhibitor treatment with reduced indices of subclinical atherosclerosis in patients with psoriatic disease. Arthritis Rheumatol 70(3):408–416. https://doi.org/10.1002/art.40366 CrossRefPubMed

35.

Welsh P, Tuckwell K, McInnes IB, Sattar N (2016) Effect of IL-6 receptor blockade on high-sensitivity troponin T and NT-proBNP in rheumatoid arthritis. Atherosclerosis 254:167–171. https://doi.org/10.1016/j.atherosclerosis.2016.10.016 CrossRefPubMedPubMedCentral

36.

Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, Fonseca F, Nicolau J, Koenig W, Anker SD, Kastelein JJP, Cornel JH, Pais P, Pella D, Genest J, Cifkova R, Lorenzatti A, Forster T, Kobalava Z, Vida-Simiti L, Flather M, Shimokawa H, Ogawa H, Dellborg M, Rossi PRF, Troquay RPT, Libby P, Glynn RJ, Group CT (2017) Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 377(12):1119–1131. https://doi.org/10.1056/nejmoa1707914 CrossRefPubMed

37.

deFilippi CR, de Lemos JA, Christenson RH, Gottdiener JS, Kop WJ, Zhan M, Seliger SL (2010) Association of serial measures of cardiac troponin T using a sensitive assay with incident heart failure and cardiovascular mortality in older adults. JAMA 304(22):2494–2502. https://doi.org/10.1001/jama.2010.1708 CrossRefPubMedPubMedCentral

38.

Eriksson JK, Jacobsson L, Bengtsson K, Askling J (2017) Is ankylosing spondylitis a risk factor for cardiovascular disease, and how do these risks compare with those in rheumatoid arthritis? Ann Rheum Dis 76(2):364–370. https://doi.org/10.1136/annrheumdis-2016-209315 CrossRefPubMed

39.

Bengtsson K, Forsblad-d’Elia H, Lie E, Klingberg E, Dehlin M, Exarchou S, Lindstrom U, Askling J, Jacobsson LTH (2017) Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events? A prospective nationwide population-based cohort study. Arthritis Res Ther 19(1):102. https://doi.org/10.1186/s13075-017-1315-z CrossRefPubMedPubMedCentral

Title: Prevalence of high-sensitivity cardiac troponin T in real-life cohorts of psoriatic arthritis and general population: a cross-sectional study
Authors: Victoria Furer
Shani Shenhar-Tsarfaty
Shlomo Berliner
Uri Arad
Daphna Paran
Inna Mailis
Ori Rogowski
David Zeltser
Itzhak Shapira
Hagit Matz
Ori Elkayam
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Vulgar Psoriasis
Psoriatic Arthritis
Published in: Rheumatology International / Issue 3/2020
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-019-04461-y

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