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Polyarticular evolution and late‐onset psoriasis may be associated with cardiovascular disease in psoriatic arthritis
Author(s) -
Queiro Rubén,
Lorenzo Andrés,
Tejón Patricia,
Pardo Estefanía,
Coto Pablo,
Ballina Javier
Publication year - 2019
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13421
Subject(s) - medicine , psoriatic arthritis , psoriasis , odds ratio , diabetes mellitus , univariate analysis , obesity , logistic regression , multivariate analysis , gastroenterology , arthritis , disease , dermatology , endocrinology
Background and aims Patients with psoriatic arthritis (PsA) have high prevalence of cardiovascular risk factors (CVRF), and they also show higher rates of cardiovascular disease (CVD). We aimed to corroborate these findings and identify factors associated with these events in our clinical setting. Methods This cross‐sectional study included 340 consecutive patients seen in a tertiary care hospital. The prevalence of CVRF was compared to that of 600 outpatients without inflammatory conditions. To analyze CVD‐associated factors, odds ratio (OR) values were calculated by conditional logistic regression analysis. Significant variables in the univariate analysis were then introduced in a multivariate analysis with a backward stepwise approach. Results Patients with psoriatic arthritis had higher frequencies of hypertension (36% vs 23%, OR 2.4, 95%CI: 1.6‐2.7, P < 0.0001), diabetes (13.8% vs 5%, OR 2.8, 95%CI: 1.7‐4.3, P < 0.0001), obesity (35% vs 22%, OR 2.1, 95%CI: 1.5‐2.8, P < 0.0001) and tobacco use (26% vs 21%, OR 1.4, 95%CI: 1.0‐1.8, P < 0.05). More PsA patients had CVD compared to non‐inflammatory patients (9.4% vs 5.8%, OR 1.68, 95%CI: 1.02‐2.76, P < 0.05). Independent CVD‐associated factors were: an age of onset of psoriasis >40 years (OR 3.4, 95%CI: 1.1‐10.0, P < 0.05), a high number of swollen joints during evolution (OR 2.9, 95%CI: 1.1‐8.0, P < 0.05), hypertension (OR 5.3, 95%CI: 1.6‐17.6, P < 0.01) and dyslipidemia (OR 2.6, 95%CI: 1.0‐7.2, P < 0.05). Conclusions Cardiovascular risk should be carefully evaluated in patients with PsA whose disease presents a high inflammatory burden and in those with late‐onset psoriasis.