To evaluate the frequency of cardiovascular (CV) risk factors in psoriatic arthritis (PsA) patients. The study included 97 PsA patients and 30 control. Lipid profile and serum homocysteine level were assessed. The endothelium-dependent vasodilation (EDVD) evaluated. The QRISK-3 scale was used to assess CV risk. Disease activity PsA (DAPSA) and psoriasis area and severity index (PASI) were recorded. Reduced EDVD (<10 %) was significantly more frequent in PsA compared to control (75.3 % vs. 6.7 %, p < 0.001), with significant differences in lipid profile (p < 0.001), homocysteine (p < 0.001), QRISK (p < 0.001), CRP (p < 0.001), DAPSA (p < 0.001), and disease duration (p < 0.001) between PsA patients with reduced and normal EDVD. Average CV risk was 7.7 times higher than in control, and the classical risk factors did not account for the reduced EDVD. Linear regression analysis identified disease duration (β 0.5; OR 1.65, p < 0.001) and disease activity (β 0.09; OR 1.09, p < 0.001) as significant predictors of CV risk in PsA patients. The predictive accuracy of DAPSA (sensitivity 69 %, specificity 86.4 %, 95 % CI: 0.7–0.9; p < 0.001) and disease duration (sensitivity 91 %, specificity 55 %, 95 % CI: 0.95–1; p < 0.001) for CV risk was determined. A heightened CV risk in PsA patients is highlightened independent of traditional risk factors. The significance of disease activity and disease duration as robust predictors of CV risk in PsA patients is emphasized. The data on hyperhomocysteinemia and its association with endothelial dysfunction emphasize the intricate link between PsA, homocysteine levels, and increased CV risk. 

Modern determinants of cardiovascular risk factors in patients with psoriatic arthritis: Relation to disease activity and severity

Background Psoriatic arthritis (PsA) is classified as a form of chronic inflammatory arthritis. Atherosclerosis is primarily triggered and exacerbated by the initial inflammatory response. Early detection of atherosclerosis in PsA may help develop interventions for the prompt identification and better management patients. Aim Assessing the probability of early atherosclerotic changes in PsA patients Patients and methods A total of 60 PsA patients who satisfied the ClASsification criteria for Psoriatic Arthritis and forty control subjects who underwent a thorough medical history, physical examination, erythrocyte sedimentation rate, and C-reactive protein testing were the patients of a case-control study. Using the disease activity in psoriatic arthritis score, disease activity is assessed. All patients and controls had their flow-mediated dilatation of brachial artery evaluated and measurement of carotid intima-media thickness. Results There was no discernible difference between the two studded groups based on their demographic data. PsA patients were 33.4±6.03 years old on average. The mean of BMI was 27.02±1.7 kg/m 2 . With P values of 0.015 and 0.005, respectively, patients with PsA had shown statistically significant decreases in brachial artery flow mediated dilatation when compared with control group. There is statistically significant increased CIMT in PsA patients compared with control group. Conclusion The study concludes to that PsA correlates with a heightened risk of early atherosclerotic changes and cardiovascular disease. 

Assessment of early risk factors of atherosclerosis in patients with psoriatic arthritis

OBJECTIVE
Cardiovascular atherosclerotic comorbidities represent an important cause of morbidity and mortality in patients diagnosed with psoriatic arthritis. In both atherosclerosis and Psoriatic arthritis, inflammation plays a pivotal role. Psoriatic arthritis is considered as an independent risk factor for the development of atherosclerosis with accelerated evolution. Development of atherosclerosis is initiated by the endothelial cell dysfunction along with inflammation and insulin resistance. The main aim of the study was to evaluate the endothelial function in Psoriatic arthritis patients, and to identify if it is related to the insulin resistance and Psoriatic arthritis disease activity.


PATIENTS AND METHODS
In this case-control study, a group of 32 age and gender matched healthy controls was formed and compared to the group of 32 Psoriatic arthritis patients. We assessed the following parameters: Disease Activity in Psoriatic Arthritis Score, Homeostatic Model Assessment for Insulin Resistance, serum levels of the tumor necrosis factor alpha (TNFα), and the endothelial dysfunction by means of the flow-mediated dilation at brachial artery. The Student's t-test, the Pearson correlation and the ANOVA test were used to perform the statistical analysis of the data obtained; p-value <0.05 was considered as statistically significant.


RESULTS
Compared to the patients in the control group, TNFα and Homeostatic Model Assessment for Insulin Resistance were increased (p-value <0.001), and flow-mediated dilation at brachial artery was decreased (p-value <0.001) in the disease group. In Psoriatic arthritis patients, significant correlations were found between Disease Activity in Psoriatic Arthritis Score and Homeostatic Model Assessment for Insulin Resistance (r=0.8143, p-value <0.001), and between Disease Activity in Psoriatic Arthritis Score and flow-mediated dilation at brachial artery % (r= -0.8376, p-value <0.001). Psoriatic arthritis patients treated with Methotrexate exhibited reduced values of Disease Activity in Psoriatic Arthritis Score and Homeostatic Model Assessment for Insulin Resistance and increased values of flow-mediated dilation at brachial artery, when compared with the untreated patients.


CONCLUSIONS
Endothelial dysfunction is present in Psoriatic arthritis patients and has a significant correlation with both, the course of the disease and the insulin resistance.

Endothelial dysfunction in psoriatic arthritis patients: correlations between insulin resistance and disease activity.

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Endothelial dysfunction in psoriatic arthritis patients: correlations between insulin resistance and disease activity.