The largest study of its kind has found further evidence that patients with severe psoriasis are at a higher risk of cardiovascular complications.
The study, published in the Journal of Investigative Dermatology, involved 503 patients with psoriasis but no clinical signs of cardiovascular disease.
The research showed that over 30% of asymptomatic patients with psoriasis exhibited signs of coronary microvascular dysfunction, assessed through transthoracic Doppler echocardiography.
This dysfunction was measured via the coronary flow reserve (CFR).
Notably, the study found that:
- The severity and duration of psoriasis were independently associated with lower CFR.
- Patients with psoriatic arthritis also showed lower CFR.
- Conventional cardiovascular risk factors like smoking, high lipid levels, and diabetes were not independently linked to reduced CFR in severe psoriasis patients.
Importance of Findings
Lead investigator Stefano Piaserico, MD, Ph.D., emphasized that although prior studies established that severe psoriasis patients face higher cardiovascular risks, the mechanisms remained unclear.
This study particularly investigated coronary microvascular dysfunction, a condition previously underexplored in relation to psoriasis.
The study adds weight to existing literature which suggests that systemic inflammation, common in conditions like psoriasis, rheumatoid arthritis, and lupus, plays a role in the development of cardiovascular issues.
Clinical Implications
Dr. Piaserico recommends that clinicians should actively look for signs of microvascular dysfunction in patients with severe psoriasis due to their elevated risk.
He also suggested that early and effective treatment of psoriasis might restore coronary microvascular function and reduce the future risk of myocardial infarction and heart failure.
Preliminary studies indicate that treatment with biologics could restore coronary microvascular dysfunction, although further prospective research is needed to confirm these findings.
Conclusion
The study highlights the need for an integrated approach to managing psoriasis and associated cardiovascular risks.
It calls for further investigation into the potential benefits of early treatment interventions and their impact on cardiovascular health among psoriasis patients.
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The research findings can be found in the Journal of Investigative Dermatology.
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