The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Identifying Cardiovascular Risk Factors in Psoriatic Arthritis

Identifying Cardiovascular Risk Factors in Psoriatic Arthritis

November 19, 2018 • By Larry Beresford

  • Tweet
  • Email
Print-Friendly Version / Save PDF
Iaremenko Sergii / shutterstock.com

Iaremenko Sergii / shutterstock.com

Psoriatic arthritis (PsA), like other inflammatory diseases, has been associated with increased incidence for and mortality from cardio­vascular disease (CVD), the most common comorbidity leading to death in many conditions treated by rheumatologists. But beyond recognizing the burden of increased inflammation, the mechanisms behind this association are not well understood, says M. Elaine Husni, MD, MPH, vice chair of rheumatology at the Cleveland Clinic in Ohio. “Just having [PsA] itself puts you at greater risk, but the reason why is not known,” she tells The Rheumatologist.

You Might Also Like
  • Patients with Psoriasis, Psoriatic Arthritis at Increased Risk of Migraine
  • Patients with Psoriatic Arthritis at Increased Risk for Type 2 Diabetes
  • Psoriatic Arthritis Linked to Increased Heart Disease Risk
Explore This Issue
November 2018
Also By This Author
  • CCL2 Cytokine Serves as Biomarker in Interstitial Lung Disease

“There is [an] unmet need to precisely identify those patients with PsA who are at greatest risk of developing cardiovascular comorbidities,” Dr. Husni and colleagues note in a new research study published in the journal Arthritis & Rheumatology.1 They examined associations involving HDL (high-density lipoprotein, the so-called good cholesterol), and its activity in the blood with cardiovascular risk.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

The researchers measured serum levels for paraoxonase and arylesterase, two antioxidant enzymatic proteins known to protect lipoproteins from oxidation and thereby provide defense against cardiovascular diseases. They compared levels of activity for these two enzymes in patients with either psoriasis or PsA with levels in healthy adult, volunteer controls. They also looked at the extent of inflammatory disease activity as measured by standard scores, such as the Disease Activity Score in 28 joints (DAS28); the Clinical Disease Activity Index; severity of pre-existing cardio­vascular disease; risk factors, such as diabetes, hypertension and smoking; and lab test findings, such as erythrocyte sedimentation rate and C-reactive protein.

Decreases in HDL-associated paraoxonase (PON1) enzyme activity have been previously shown to predict major CVD-
related adverse events.2 PON1 activity and cardiovascular disease have also been studied in rheumatoid arthritis and systemic lupus erythematosus, with similar results.3,4

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

The new study enrolled 343 patients with either psoriasis or PsA in a longitudinal, prospective psoriatic disease registry, called the Cardiometabolic Outcome Measures in Psoriatic Arthritis Study (COMPASS), which started at Cleveland Clinic in 2011. The study compared these patients with 345 healthy controls.5

‘The HDL level goes deeper than [the] number itself, & it is the HDL function we need to understand,’ Dr. Husni notes.

The researchers found that serum arylesterase activity was significantly lower for patients with both psoriasis and PsA compared with healthy controls, decreasing in tandem with increased inflammatory disease activity for those with PsA. But they found no correlation with extent of disease or cardiovascular burden for patients with psoriasis, and no association between serum paraoxonase activity and extent of disease or cardiovascular burden in either disease cohort. This suggests arylesterase activity may be a more sensitive predictor of pre-existing cardiovascular disease than paraoxonase.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

An additional factor in these complex associations is the higher use of DMARDs (disease-modifying anti-rheumatic drugs) in patients with PsA (70%) vs. psoriasis (24%), which could have influenced the relatively low inflammatory disease activity levels seen in some of those patients.

Pages: 1 2 3 | Single Page

Filed Under: Conditions, Research Reviews, Systemic Inflammatory Syndromes Tagged With: Cardiovascular disease, PsA, Psoriatic ArthritisIssue: November 2018

You Might Also Like:
  • Patients with Psoriasis, Psoriatic Arthritis at Increased Risk of Migraine
  • Patients with Psoriatic Arthritis at Increased Risk for Type 2 Diabetes
  • Psoriatic Arthritis Linked to Increased Heart Disease Risk
  • Psoriatic Arthritis: Recognize, Manage Comorbidities

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.