Top

Published in:

01-08-2019 | Obesity | Original Article

Cardiac and cardiovascular morbidities in patients with psoriatic arthritis: a population-based case control study

Authors: Adi Kibari, Arnon D. Cohen, Tal Gazitt, Haim Bitterman, Idit Lavi, Ilan Feldhamer, Guy Shalom, Sari Greenberg-Dotan, Devy Zisman

Published in: Clinical Rheumatology | Issue 8/2019

Abstract

Objective

To assess the prevalence of risk factors associated with cardiovascular disease (CVD) and CVD-related morbidity in a large Middle-Eastern psoriatic arthritis (PsA) cohort.

Method

A retrospective case control study was conducted using Israel’s largest health care provider’s patient database from 2000 to 2013. For each patient with PsA, 10 patients with no history of psoriasis or arthritis were matched for age and sex. Analysis of CVD-related risk factors and morbidity included hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus type 2 (DM-2), obesity, smoking, ischemic heart disease (IHD), congestive heart failure (CHF), cerebrovascular accident (CVA), carotid artery disease, peripheral vascular disease (PVD), aortic aneurism, valvular heart disease (VHD), and cardiomyopathy. Statistical analysis was conducted using t test and chi-square tests as appropriate. Univariate and multivariable logistic regression models assessed the association between PsA and CVD-related risk factors and morbidity.

Results

Three thousand one hundred sixty-one PsA patients were included, with average age 58 ± 15.0 years, of whom 53.4% were women. Increased prevalence of DM-2, HLD, HTN, and obesity (OR 1.7, 1.5, 1.5, 1.5 respectively) was noted in the PsA group. Increased prevalence of IHD (p < 0.0001), PVD (p < 0.0001), CHF (p = 0.002), VHD (p < 0.0001), and cardiomyopathy (p = 0.006) was found in the PsA group compared to the control group even after adjusting for CVD risk factors.

Conclusions

A high prevalence of CVD-related risk factors and morbidity was found in this Middle Eastern PsA population, in accordance with data from other geographic regions. These results emphasize the importance of clinician awareness of the increased risk for CVD-related complications in PsA patients.

Husni ME, Mease PJ (2010) Managing comorbid disease in patients with psoriatic arthritis. Curr Rheumatol Rep 12:281–287CrossRefPubMed

Horreau C, Pouplard C, Brenaut E, Barnetche T, Misery L, Cribier B, Jullien D, Aractingi S, Aubin F, Joly P, le Maître M, Ortonne JP, Paul C, Richard MA (2013) Cardiovascular morbidity and mortality in psoriasis and psoriatic arthritis: a systematic literature review. J Eur Acad Dermatol Venereol 27:12–29CrossRefPubMed

Russolillo A, Iervolino S, Peluso R, Lupoli R, di Minno A, Pappone N, di Minno MND (2013) Obesity and psoriatic arthritis: from pathogenesis to clinical outcome and management. Rheumatol 52:62–67CrossRef

Tam LS, Tomlinson B, Chu TW et al (2008) Cardiovascular risk profile of patients with psoriatic arthritis compared to controls—the role of inflammation. Rheumatol 47:718–723CrossRef

Jamnitski A, Symmons D, Peters MJ et al (2013) Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. Ann Rheum Dis 72:211–216CrossRefPubMed

Han C, Robinson DW, Hackett MV et al (2006) Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol 33:2167–2172PubMed

Gladman DD, Ang M, Su L, Tom BD et al (2009) Cardiovascular morbidity in psoriatic arthritis. Ann Rheum Dis 68:1131–1135CrossRefPubMed

Rennert G, Peterburg Y (2001) Prevalence of selected chronic diseases in Israel. Isr Med Assoc J 3:404–408PubMed

Zisman D, Bitterman H, Shalom G, Feldhamer I, Comanesther D, Batat E, Greenberg-Dotan S, Cohen S, Cohen AD (2016) Psoriatic arthritis treatment and the risk of herpes zoster. Ann Rheum Dis 75:131–135CrossRefPubMed

10.

Dreiher J, Kresch FS, Comaneshter D, Cohen AD (2012) Risk of Herpes zoster in patients with psoriasis treated with biologic drugs. J Eur Acad Dermatol Venereol 26:1127–1132CrossRefPubMed

11.

Cohen AD, Weitzman D, Birkenfeld S, Dreiher J (2010) Psoriasis associated with hepatitis C but not with hepatitis B. Dermatol 220:218–222CrossRef

12.

Kimhi O, Caspi D, Bornstein NM, Maharshak N, Gur A, Arbel Y, Comaneshter D, Paran D, Wigler I, Levartovsky D, Berliner S (2007) Prevalence and risk factors of atherosclerosis in patients with psoriatic arthritis. Semin Arthritis Rheum 36:203–209CrossRefPubMed

13.

Mok CC, Ko GTC, Ho LY, Yu KL, Chan PT, To CH (2011) Prevalence of atherosclerotic risk factors and the metabolic syndrome in patients with chronic inflammatory arthritis. Arthritis Care Res 63:195–202CrossRef

14.

Khraishi M, Aslanov R, Rampakakis E, Pollock C, Sampalis JS (2014) Prevalence of cardiovascular risk factors in patients with psoriatic arthritis. Clin Rheumatol 33:1495–1500CrossRefPubMed

15.

Gulati AM, Semb AG, Rollefstad S, Romundstad PR, Kavanaugh A, Gulati S, Haugeberg G, Hoff M (2016) On the HUNT for cardiovascular risk factors and disease in patients with psoriatic arthritis: population-based data from the Nord-Trøndelag Health Study. Ann Rheum Dis 75:819–824CrossRefPubMed

16.

Johnsson H, McInnes IB, Sattar N (2012) Cardiovascular and metabolic risks in psoriasis and psoriatic arthritis: pragmatic clinical management based on available evidence. Ann Rheum Dis 71:480–483. https://doi.org/10.1136/annrheumdis-2011-200567 CrossRefPubMed

17.

Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT (2004) Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis. Semin Arthritis Rheum 34:585–592CrossRefPubMed

18.

Cognitive impairment in patients with psoriasis: a matched case-control study. Innamorati M1, Quinto RM2, Lester D3, Iani L2, Graceffa D4, Bonifati C4

19.

Korkoliakou P, Christodoulou C, Kouris A et al (2014) Alexithymia, anxiety and depression in patients with psoriasis: a case–control study. Ann General Psychiatry 13:1CrossRef

20.

Gezer O, Batmaz İ, Sariyildiz MA et al (2014) Sleep quality in patients with psoriatic arthritis. Int J Rheum Dis. https://doi.org/10.1111/1756-185X.1250

21.

Reich A, Welz-Kubiak K, Rams L (2014) Apprehension of the disease by patients suffering from psoriasis. Postep Derm Alergol 31:289–293

22.

Vogelzangs N, Seldenrijk A, Beekman AT et al (2010) Cardiovascular disease in persons with depressive and anxiety disorders. J Affect Disord 125:241–248CrossRefPubMedPubMedCentral

23.

Shapiro J, Cohen AD, Weitzman D, Tal R, David M (2012) Psoriasis and cardiovascular risk factors: a case-control study on inpatients comparing psoriasis to dermatitis. J Am Acad Dermatol 66:252–258CrossRefPubMed

24.

Cohen AD, Gilutz H, Henkin Y, Zahger D, Shapiro J, Bonneh DY, Vardy DA (2007) Psoriasis and the metabolic syndrome. Acta Derm Venereol 87:506–509CrossRefPubMed

25.

Rodriguez-Zúñiga MJM, Garcia-Perdomo HA (2017) J Am Acad Dermatol 77:657–666.e8CrossRefPubMed

26.

Svedbom A, Dalén J, Mamolo C et al (2015) Increased cause-specific mortality in patients with mild and severe psoriasis: a population-based Swedish register. Acta Derm Venereol 95(7):809–815PubMed

27.

Maisch B, Richter A, Sandmöller A, Portig I, Pankuweit S, for the members of project 9a in the BMBF-Heart Failure Network (2005) Inflammatory dilated cardiomyopathy (DCMI). Herz. 30(6):535–544CrossRefPubMed

28.

Biyik I, Narin A, Bozok MA, Ergene O (2006) Echocardiographic and clinical abnormalities in patients with psoriasis. J Int Med Res 34(6):632–639CrossRefPubMed

29.

Ramonda R, Lo Nigro A, Modesti V, Nalotto L, Musacchio E, Iaccarino L, Punzi L, Doria A (2011) Atherosclerosis in psoriatic arthritis. Autoimmun Rev 10(12):773–778CrossRefPubMed

30.

Yim KM, Armstrong AW (2016) Updates on cardiovascular comorbidities associated with psoriatic diseases: epidemiology and mechanisms. Rheumatol Int 37:97–105. https://doi.org/10.1007/s00296-016-3487-2 CrossRefPubMed

31.

Boehncke WH, Boehncke S (2012) Cardiovascular mortality in psoriasis and psoriatic arthritis: epidemiology, pathomechanisms, therapeutic implications, and perspectives. Curr Rheumatol Rep 14:343–348CrossRefPubMed

32.

Atzeni F, Turiel M, Boccassini L et al (2011) Cardiovascular involvement in psoriatic arthritis. Reumatismo 63:148–154CrossRefPubMed

33.

Eder L, Zisman D, Barzilai M, Laor A, Rahat M, Rozenbaum M, Bitterman H, Feld J, Rimar D, Rosner I (2008) Subclinical atherosclerosis in psoriatic arthritis: a case-control study. J Rheumatol 35:877–882PubMed

34.

Eder L, Chandran V, Gladman DD (2013) The Framingham Risk Score underestimates the extent of subclinical atherosclerosis in patients with psoriatic disease. Ann Rheum Dis 73:1990–1996CrossRefPubMed

35.

Ramonda R, Puato M, Punzi L, Rattazzi M, Zanon M, Balbi G, Ortolan A, Frallonardo P, Faggin E, Plebani M, Zaninotto M, Lorenzin M, Pauletto P, Doria A (2014) Atherosclerosis progression in psoriatic arthritis patients despite the treatment with tumor necrosis factor-alpha blockers: a two-year prospective observational study. Joint Bone Spine 81(5):421–425CrossRefPubMed

36.

Kristensen SL, McInnes IB, Sattar N (2015) Psoriasis, psoriatic arthritis and cardiovascular risk: are we closer to a clinical recommendation? Ann Rheum Dis 74:321–322CrossRefPubMed

37.

Ernste FC, Sánchez-Menéndez 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 67:1015–1021CrossRef

Title: Cardiac and cardiovascular morbidities in patients with psoriatic arthritis: a population-based case control study
Authors: Adi Kibari
Arnon D. Cohen
Tal Gazitt
Haim Bitterman
Idit Lavi
Ilan Feldhamer
Guy Shalom
Sari Greenberg-Dotan
Devy Zisman
Publication date: 01-08-2019
Publisher: Springer London
Keywords: Obesity
Obesity
Cardiomyopathy
Valvular Heart Disease
Vulgar Psoriasis
Peripheral Arterial Disease
Psoriatic Arthritis
Peripheral Arterial Disease
Hypertension
Type 2 Diabetes
Hypertension
Published in: Clinical Rheumatology / Issue 8/2019
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04528-y

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Cardiac and cardiovascular morbidities in patients with psoriatic arthritis: a population-based case control study

Abstract

Objective

Method

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Method

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2019

Uncommon presentations in ANCA vasculitis: clinical characteristics and outcomes

Value of serum procalcitonin for the diagnosis of bacterial septic arthritis in daily practice in rheumatology

Comment on “Seasonal variations of Google searches for joint swelling: implications for patient-reported outcomes”

Correction to: Vitamin D receptor expression in peripheral blood mononuclear cells is inversely associated with disease activity and inflammation in lupus patients

Evolving patterns of reactive arthritis

Clinical characteristics of rheumatoid arthritis patients with peripheral neuropathy and potential related risk factors

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page