Prevalence and severity of coronary artery disease linked to prognosis in psoriasis and psoriatic arthritis patients: A multi-centre cohort study

Andreas Bugge Tinggaard; Kasper Fjellhaugen Hjuler; Ina Trolle Andersen; Simon Winther; Lars Iversen; Morten Bøttcher

doi:10.1111/joim.13311

Prevalence and severity of coronary artery disease linked to prognosis in psoriasis and psoriatic arthritis patients: A multi-centre cohort study

Andreas Bugge Tinggaard, Kasper Fjellhaugen Hjuler, Ina Trolle Andersen, Simon Winther, Lars Iversen, Morten Bøttcher

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Objectives: (i) To estimate the prevalence and severity of coronary artery disease and (ii) to assess the risk of cardiovascular events and mortality, in patients with psoriasis and psoriatic arthritis (PsA) in a large-scale cohort of patients referred to coronary computed tomography angiography (CTA). Methods: This was a cross-sectional study with follow-up of 46,022 patients based on data from a Danish national CTA registry. Exposure was defined as psoriasis or PsA. A group of patients without psoriasis, PsA or any other inflammatory disease was used as reference. Cross-sectional primary outcomes were a coronary artery calcium score (CACS) >0 and CACS ≥400, and secondary outcome was obstructive CAD. At follow-up, the primary outcome was a composite endpoint of cardiovascular events and all-cause mortality. All outcomes were adjusted for traditional cardiovascular risk factors. Results: We identified 1356 psoriasis and 370 PsA patients. The adjusted odds ratio (OR) for psoriasis patients for CACS >0, CACS ≥400 and obstructive CAD was 1.26 (1.10–1.46), 1.25 (1.04–1.50) and 1.14 (0.98–1.33), respectively. For PsA patients, OR for CACS >0 was 1.28 (1.00–1.64). We found a crude hazard ratio (HR) of 1.49 (1.21–1.85) and adjusted HR of 1.14 (0.92–1.41) for the primary outcome in psoriasis patients. Conclusions: In this population, both psoriasis and PsA were associated with an increased prevalence of coronary calcification. Psoriasis patients also showed an increased prevalence of severe calcification. Psoriasis patients were at increased risk for cardiovascular events and death, however not after adjusting for the effect of other predictors.

Originalsprog	Engelsk
Tidsskrift	Journal of Internal Medicine
Vol/bind	290
Nummer	3
Sider (fra-til)	693-703
Antal sider	11
ISSN	0954-6820
DOI	https://doi.org/10.1111/joim.13311
Status	Udgivet - sep. 2021

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10.1111/joim.13311

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title = "Prevalence and severity of coronary artery disease linked to prognosis in psoriasis and psoriatic arthritis patients: A multi-centre cohort study",

abstract = "Objectives: (i) To estimate the prevalence and severity of coronary artery disease and (ii) to assess the risk of cardiovascular events and mortality, in patients with psoriasis and psoriatic arthritis (PsA) in a large-scale cohort of patients referred to coronary computed tomography angiography (CTA). Methods: This was a cross-sectional study with follow-up of 46,022 patients based on data from a Danish national CTA registry. Exposure was defined as psoriasis or PsA. A group of patients without psoriasis, PsA or any other inflammatory disease was used as reference. Cross-sectional primary outcomes were a coronary artery calcium score (CACS) >0 and CACS ≥400, and secondary outcome was obstructive CAD. At follow-up, the primary outcome was a composite endpoint of cardiovascular events and all-cause mortality. All outcomes were adjusted for traditional cardiovascular risk factors. Results: We identified 1356 psoriasis and 370 PsA patients. The adjusted odds ratio (OR) for psoriasis patients for CACS >0, CACS ≥400 and obstructive CAD was 1.26 (1.10–1.46), 1.25 (1.04–1.50) and 1.14 (0.98–1.33), respectively. For PsA patients, OR for CACS >0 was 1.28 (1.00–1.64). We found a crude hazard ratio (HR) of 1.49 (1.21–1.85) and adjusted HR of 1.14 (0.92–1.41) for the primary outcome in psoriasis patients. Conclusions: In this population, both psoriasis and PsA were associated with an increased prevalence of coronary calcification. Psoriasis patients also showed an increased prevalence of severe calcification. Psoriasis patients were at increased risk for cardiovascular events and death, however not after adjusting for the effect of other predictors.",

keywords = "computed tomography angiography, coronary artery disease, psoriasis, psoriatic arthritis, SYSTEM, MANAGEMENT, MORBIDITY, MYOCARDIAL-INFARCTION, CARDIOVASCULAR EVENTS, CALCIUM, RISK, PLAQUE",

author = "Tinggaard, {Andreas Bugge} and Hjuler, {Kasper Fjellhaugen} and Andersen, {Ina Trolle} and Simon Winther and Lars Iversen and Morten B{\o}ttcher",

note = "{\textcopyright} 2021 The Association for the Publication of the Journal of Internal Medicine.",

year = "2021",

month = sep,

doi = "10.1111/joim.13311",

language = "English",

volume = "290",

pages = "693--703",

journal = "Journal of Internal Medicine",

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Prevalence and severity of coronary artery disease linked to prognosis in psoriasis and psoriatic arthritis patients: A multi-centre cohort study. / Tinggaard, Andreas Bugge; Hjuler, Kasper Fjellhaugen; Andersen, Ina Trolle et al.
I: Journal of Internal Medicine, Bind 290, Nr. 3, 09.2021, s. 693-703.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Prevalence and severity of coronary artery disease linked to prognosis in psoriasis and psoriatic arthritis patients

T2 - A multi-centre cohort study

AU - Tinggaard, Andreas Bugge

AU - Hjuler, Kasper Fjellhaugen

AU - Andersen, Ina Trolle

AU - Winther, Simon

AU - Iversen, Lars

AU - Bøttcher, Morten

PY - 2021/9

Y1 - 2021/9

N2 - Objectives: (i) To estimate the prevalence and severity of coronary artery disease and (ii) to assess the risk of cardiovascular events and mortality, in patients with psoriasis and psoriatic arthritis (PsA) in a large-scale cohort of patients referred to coronary computed tomography angiography (CTA). Methods: This was a cross-sectional study with follow-up of 46,022 patients based on data from a Danish national CTA registry. Exposure was defined as psoriasis or PsA. A group of patients without psoriasis, PsA or any other inflammatory disease was used as reference. Cross-sectional primary outcomes were a coronary artery calcium score (CACS) >0 and CACS ≥400, and secondary outcome was obstructive CAD. At follow-up, the primary outcome was a composite endpoint of cardiovascular events and all-cause mortality. All outcomes were adjusted for traditional cardiovascular risk factors. Results: We identified 1356 psoriasis and 370 PsA patients. The adjusted odds ratio (OR) for psoriasis patients for CACS >0, CACS ≥400 and obstructive CAD was 1.26 (1.10–1.46), 1.25 (1.04–1.50) and 1.14 (0.98–1.33), respectively. For PsA patients, OR for CACS >0 was 1.28 (1.00–1.64). We found a crude hazard ratio (HR) of 1.49 (1.21–1.85) and adjusted HR of 1.14 (0.92–1.41) for the primary outcome in psoriasis patients. Conclusions: In this population, both psoriasis and PsA were associated with an increased prevalence of coronary calcification. Psoriasis patients also showed an increased prevalence of severe calcification. Psoriasis patients were at increased risk for cardiovascular events and death, however not after adjusting for the effect of other predictors.

AB - Objectives: (i) To estimate the prevalence and severity of coronary artery disease and (ii) to assess the risk of cardiovascular events and mortality, in patients with psoriasis and psoriatic arthritis (PsA) in a large-scale cohort of patients referred to coronary computed tomography angiography (CTA). Methods: This was a cross-sectional study with follow-up of 46,022 patients based on data from a Danish national CTA registry. Exposure was defined as psoriasis or PsA. A group of patients without psoriasis, PsA or any other inflammatory disease was used as reference. Cross-sectional primary outcomes were a coronary artery calcium score (CACS) >0 and CACS ≥400, and secondary outcome was obstructive CAD. At follow-up, the primary outcome was a composite endpoint of cardiovascular events and all-cause mortality. All outcomes were adjusted for traditional cardiovascular risk factors. Results: We identified 1356 psoriasis and 370 PsA patients. The adjusted odds ratio (OR) for psoriasis patients for CACS >0, CACS ≥400 and obstructive CAD was 1.26 (1.10–1.46), 1.25 (1.04–1.50) and 1.14 (0.98–1.33), respectively. For PsA patients, OR for CACS >0 was 1.28 (1.00–1.64). We found a crude hazard ratio (HR) of 1.49 (1.21–1.85) and adjusted HR of 1.14 (0.92–1.41) for the primary outcome in psoriasis patients. Conclusions: In this population, both psoriasis and PsA were associated with an increased prevalence of coronary calcification. Psoriasis patients also showed an increased prevalence of severe calcification. Psoriasis patients were at increased risk for cardiovascular events and death, however not after adjusting for the effect of other predictors.

KW - computed tomography angiography

KW - coronary artery disease

KW - psoriasis

KW - psoriatic arthritis

KW - SYSTEM

KW - MANAGEMENT

KW - MORBIDITY

KW - MYOCARDIAL-INFARCTION

KW - CARDIOVASCULAR EVENTS

KW - CALCIUM

KW - RISK

KW - PLAQUE

U2 - 10.1111/joim.13311

DO - 10.1111/joim.13311

M3 - Journal article

C2 - 33978283

SN - 0954-6820

VL - 290

SP - 693

EP - 703

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

IS - 3

ER -

Prevalence and severity of coronary artery disease linked to prognosis in psoriasis and psoriatic arthritis patients: A multi-centre cohort study

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