Patients with severe psoriasis are at a higher risk for heart disease, study confirms

In the largest study to date exploring the relationship between severe psoriasis and coronary microvascular dysfunction, researchers have found further evidence that patients with severe psoriasis are at higher cardiovascular risk.

Psoriasis is a chronic systemic immune-mediated inflammatory disease that affects 1-3% of the global population. In this study, a total of 503 patients with psoriasis, and without clinical cardiovascular disease, underwent transthoracic Doppler echocardiography to evaluate coronary microcirculation. Investigators uncovered a high prevalence of coronary microvascular dysfunction in more than 30% of asymptomatic patients within the study population.

The study revealed that psoriasis severity, assessed by the Psoriasis Area Severity Index (PASI) score, and the duration of the disease were independently associated with lower CFR, along with the presence of psoriatic arthritis. Furthermore, results from the study showed that conventional cardiovascular risk factors, such as tobacco use, hyperlipidemia, and diabetes mellitus, were not independently associated with reduced CFR in patients with severe psoriasis. These findings emphasize the importance of considering inflammation and psoriasis-related factors in assessing cardiovascular risk in patients with severe psoriasis.

The findings shed light on the potential mechanism by which psoriasis increases the risk of cardiovascular complications in affected individuals, in agreement with previous studies on chronic inflammatory conditions, such as rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis. The study supports the role of systemic inflammation in the development of coronary microvascular dysfunction.

Reference: Coronary Microvascular Dysfunction in Asymptomatic Patients with Severe Psoriasis Journal of Investigative Dermatology, DOI 10.1016/j.jid.2023.02.037