JAAD international · 2025
Prevalence, multiterritorial vascular distribution, and burden of subclinical atherosclerosis in psoriasis: The EDSAP study.
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Abbad-Jaime de Aragon Carlota, Berna-Rico Emilio, Lecumberri Alba, Perez-Bootello Javier, Davó-Mogica María, Neria-Serrano Fernando, Monge Diana, Ballester-Martínez María Asunción, Pindado-Ortega Cristina, Castellanos-González María, Llamas-Velasco Mar, Wasniewski Samantha, Barderas María G, Jaén Pedro, Gelfand Joel M, Mehta Nehal N, Solís Jorge, Fernández-Friera Leticia, González-Cantero Álvaro
Аннотация
BACKGROUND: Psoriasis increases atherosclerosis risk due to inflammation. To date, subclinical atherosclerosis (SA) in psoriasis has only been studied in individual vascular territories by imaging.
OBJECTIVE: To conduct a comprehensive evaluation of multiterritorial SA prevalence in psoriasis by imaging and establish its relationships with cardiovascular (CV) risk scores.
METHODS: A total of 120 patients with moderate-to-severe psoriasis without CV disease from the Early Detection of Subclinical Atherosclerosis in Psoriasis (EDSAP) cohort underwent vascular ultrasound of carotid/femoral arteries and noncontrast/contrast-coronary computed tomography angiography. SA was defined by the presence of any plaque or a coronary artery calcium score ≥1.
RESULTS: The median age was 48.04 (8.25) years, 73% were male, and 77% of participants had SA. Femoral arteries were most affected (57.1%), followed by the coronaries (51.3%) and carotid arteries (49.6%). Femoral plaques exhibited the strongest associations with coronary parameters. CV risk scores underestimated SA, as at least 60% low-risk and 90% moderate-risk patients had SA.
LIMITATIONS: The main limitation is the small sample size.
CONCLUSIONS: This study provides the first multiterritorial assessment of SA in psoriasis, revealing a high prevalence of early disease. Femoral arteries were most affected, correlating with coronary atherosclerosis. The high SA detection within low-/intermediate-risk individuals suggests recalibrating CV scores for establishing effective preventive measures.
OBJECTIVE: To conduct a comprehensive evaluation of multiterritorial SA prevalence in psoriasis by imaging and establish its relationships with cardiovascular (CV) risk scores.
METHODS: A total of 120 patients with moderate-to-severe psoriasis without CV disease from the Early Detection of Subclinical Atherosclerosis in Psoriasis (EDSAP) cohort underwent vascular ultrasound of carotid/femoral arteries and noncontrast/contrast-coronary computed tomography angiography. SA was defined by the presence of any plaque or a coronary artery calcium score ≥1.
RESULTS: The median age was 48.04 (8.25) years, 73% were male, and 77% of participants had SA. Femoral arteries were most affected (57.1%), followed by the coronaries (51.3%) and carotid arteries (49.6%). Femoral plaques exhibited the strongest associations with coronary parameters. CV risk scores underestimated SA, as at least 60% low-risk and 90% moderate-risk patients had SA.
LIMITATIONS: The main limitation is the small sample size.
CONCLUSIONS: This study provides the first multiterritorial assessment of SA in psoriasis, revealing a high prevalence of early disease. Femoral arteries were most affected, correlating with coronary atherosclerosis. The high SA detection within low-/intermediate-risk individuals suggests recalibrating CV scores for establishing effective preventive measures.