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Cardiovascular Risk Profile at the Onset of Psoriatic Arthritis: A Population‐Based Cohort Study
Author(s) -
Ernste F. C.,
SánchezMenéndez M.,
Wilton K. M.,
Crowson C. S.,
Matteson E. L.,
Maradit Kremers H.
Publication year - 2015
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22536
Subject(s) - medicine , psoriatic arthritis , incidence (geometry) , population , cumulative incidence , cohort , risk factor , confidence interval , framingham heart study , cohort study , body mass index , framingham risk score , disease , environmental health , physics , optics
Objective The role of cardiovascular disease (CVD) risk factors in psoriatic arthritis (PsA) is poorly understood. We examined the prevalence of CVD risk factors at initial onset of PsA and compared the observed incidence of CVD events with that predicted by the Framingham Risk Score (FRS) to determine its applicability in this patient population. Methods A population‐based incidence cohort of 158 patients with PsA who fulfilled Classification of Psoriatic Arthritis criteria for PsA in 1989–2008 was assembled. Medical records were reviewed to ascertain CVD risk factors and CVD events. Future risk of CVD was estimated using the FRS algorithm. Results Mean age was 43.4 years (range 19–74 years), 61% were men, and 44% were obese (body mass index ≥30 kg/m 2 ). Fifty‐four patients (34%) presented with ≥2 CVD risk factors at PsA incidence. Among 126 patients ages ≥30 years at PsA incidence with no prior history of CVD, 33% had an FRS ≥10%, with 11% having an FRS ≥20%, and 18 experienced a CVD event in the first 10 years of disease duration. The 10‐year cumulative incidence of CVD events was 17% (95% confidence interval [95% CI] 10%–24%), almost twice as high as the predicted incidence based on the FRS (standardized incidence ratio 1.80, 95% CI 1.14–2.86; P = 0.012). Conclusion The majority of newly diagnosed PsA patients have a >10% risk of CVD within 10 years of PsA incidence. The CVD risk in these patients is higher than expected and underestimated by the FRS.