Atopic dermatitis and psoriasis, a systemic inflammatory disease thought to be linked to a range of comorbidities, are associated with an increased prevalence of coronary artery disease.
Background
Psoriasis and atopic dermatitis (AD) are immuno-inflammatory diseases that can result in lifelong systemic inflammation. Unlike AD, psoriasis has been associated with cardiovascular disease. The aim of this study was to examine the prevalence, severity, and subtype of coronary artery disease (CAD) in psoriasis and AD patients without known cardiovascular disease.
Methods
Consecutively enrolled patients (psoriasis n = 58, AD n = 31) and retrospectively matched controls (n = 33) were examined using cardiac computed tomography angiography (CCTA) and assessed using an 18-segment model of the coronary tree.
Results
The prevalence of a coronary artery calcium score >0 was 29.8% in psoriasis and 45.2% in AD, vs 15.2% in controls (P = .09 and P = .01, respectively). More patients with psoriasis had a coronary artery calcium score ≥100 (psoriasis 19.3%, controls 2.9%; P = .02). CCTA showed the presence of plaques in 38.2% of psoriasis patients and 48.1% of AD patients, vs 21.2% of controls (P = .08 and P = .03, respectively). Psoriasis was associated with an increased prevalence of significant coronary stenosis (stenosis >70%) (psoriasis 14.6%, controls 0%; P = .02) and 3-vessel coronary affection or left main artery disease (psoriasis 20%, controls 3%;P = .02), whereas AD was associated with mild (AD 40.7%, controls 9.1%; P = .005) single-vessel affection.
Conclusions
These findings suggest that psoriasis and AD are associated with an increased prevalence of CAD. Patients with psoriasis have an increased prevalence of severe CAD.
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– Kasper Fjellhaugen Hjuler, MD, Morten Böttcher, MD, PhD, Christian Vestergaard, MD, PhD, DMSc, Mette Deleuran, MD, DMSc, Line Raaby, MD, Hans Erik Bøtker, MD, DMSc, Lars Iversen, MD, PhD, Knud Kragballe, MD, PhD, DMSc
This article originally appeared in the December 2015 issue of The American Journal of Medicine.
