New study reveals link between psoriatic arthritis and elevated aortic stiffness

Findings from the largest carotid-femoral pulse wave velocity (cfPWV)/PsA cohort to date showed that patients with PsA exhibited increased aortic stiffness compared to healthy controls. The study, published in Rheumatology and Therapy, revealed disease duration is the most important independent predictor of elevated aortic stiffness, followed by traditional cardiovascular (CV) risk factors.

"This is one of the largest surrogate CV marker studies in psoriatic arthritis and the first report of an independent association between aortic stiffness and PsA duration suggesting a possible link with disease-related cumulative damage or comorbidities," the researchers wrote.

Psoriatic arthritis, a chronic inflammatory condition affecting the joints and skin, has long been known to correlate with a heightened risk of cardiovascular events. Aortic stiffness measured by carotid-femoral pulse wave velocity has been shown to predict CV risk in the general population. However, the mechanisms underlying this connection have remained elusive until now.

To shed light on the topic, Andreas Schwarting, University Medical Center of the Johannes Gutenberg University, Mainz, Germany, and colleagues aimed to examine cfPWV values of patients with PsA compared to healthy controls. They also evaluated associations of cfPWV with patient- and disease-associated characteristics, as well as with an established traditional CV prediction score of the European Society of Cardiology (Systemic Coronary Risk Evaluation; SCORE), for the first time.

For this purpose, the research team evaluated cfPWV and SCORE in patients with PsA and healthy controls, along with clinical and laboratory disease parameters. They statistically evaluated differences in cfPWV measurements between the two groups and associations of cfPWV with disease- and patient-associated characteristics. One hundred fifty patients with PsA (PSOCARD cohort) and 88 control subjects were recruited.

The researchers reported the following findings:

• cfPWV was significantly higher in the PsA group compared to controls, even after adjustment for confounders.
• cfPWV was independently associated with disease duration (r = 0.304), age (rho = 0.688), glomerular filtration rate (inverse: rho = − 0.264), systolic arterial pressure (rho = 0.351), and red cell distribution width, a marker of major adverse CV events (MACE) (rho = 0.190).
• SCORE revealed an elevated CV risk in 8.73% of the patients, whereas cfPWV showed increased aortic stiffness and end-organ disease in 16.00% of the same cohort.

"cfPWV measurements may help identify subclinical end-organ disease and abnormal aortic stiffness and thus assist cardiovascular risk classification in psoriatic arthritis," the researchers concluded. "Further research and follow-up data from longitudinal studies are warranted."

Reference

Triantafyllias, K., Liverakos, S., Muthuraman, M. et al. Cardiovascular Risk Evaluation in Psoriatic Arthritis by Aortic Stiffness and the Systemic Coronary Risk Evaluation (SCORE): Results of the Prospective PSOCARD Cohort Study. Rheumatol Ther (2024). https://doi.org/10.1007/s40744-024-00676-z