Cardiovascular
Association of psoriasis with prevalence, incidence and progression of coronary artery calcification – the ELSA-Brasil cohort study William R. Tebar* William Tebar Vandrize Meneghini Giuliano Generoso Alexandre C. Pereira Marcio S. Bittencourt Raul D. Santos Itamar S. Santos Paulo A. Lotufo Isabela M. Bensenor
Introduction: Psoriasis is a chronic inflammatory disease which has been associated with a cardiovascular risk burden, including coronary artery calcium (CAC). However, investigation about psoriasis and CAC incidence and progression is still scarce.
Objective: To analyze the association of psoriasis with CAC prevalence, incidence and progression in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
Methods: Data from 3824 participants (51.0±8.9 years, 53.8% women) without cardiovascular disease and with CAC exams at baseline and after a 5-year follow-up were analyzed. CAC score (in Agatston units) was analyzed by computed tomography, while psoriasis was identified by reported medical diagnosis. CAC progression was dichotomously defined by Berry method (progression vs. no progression). The association of psoriasis with CAC prevalence, CAC incidence rate, and CAC progression was analyzed by Poisson regression with robust variance estimator and adjusted by sociodemographic factors, traditional risk factors, C-reactive protein and statin use. A sensibility analysis was performed excluding statin users.
Results: At baseline, participants with psoriasis (n=107; 2.8%) had higher prevalence of CAC≥100 than those without psoriasis (17.8% vs. 8.4%, p=0.001). CAC progression was observed in 61.9% (n=13 from 21) of participants with psoriasis and in 44.9% (n=326 from 726) of participants without psoriasis (p=0.123). Psoriasis was associated with prevalent CAC≥100 (Prevalence ratio [PR]: 1.61 [1.13; 2.29]) and incident CAC≥100 (Incidence rate ratio [IRR]: 2.40 [1.33; 4.34]) in fully adjusted analyses. Psoriasis was associated with CAC progression among non-statin users (PR: 1.63 [1.19; 2.23]) even after sociodemographic adjustment but not beyond traditional risk factors.
Conclusion: Psoriasis participants had higher prevalence and incidence of moderate-to-severe CAC burden beyond traditional risk factors.
