Compared with patients with only psoriasis, patients with psoriatic arthritis (PsA) have more severe atherosclerotic disease, according to study results published in Open Access Rheumatology: Research and Reviews.

The researchers extracted data from PubMed, Web of Science, Scopus, and Embase from inception until July 2017. They included studies that had data on biomarkers of subclinical atherosclerosis in PsA.

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The search yielded 532 abstracts, which was narrowed down to 258 potentially relevant articles by reviewing titles and excluding reviews and case reports (n=274). In addition, articles were further excluded if they were not relevant to the biomarkers of subclinical atherosclerosis in psoriasis and/or PsA. Ultimately, 54 articles were eligible for the review.

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After reviewing the results, the researchers found that patients with PsA have a significantly increased risk for major adverse cardiovascular events (MACEs), particularly myocardial infarction, stroke, and cardiovascular death.

The study also indicated that chronic systemic inflammation in PsA leads to insulin resistance with endothelial dysfunction and atherosclerosis.

Compared with patients with only psoriasis, patients with PsA had significantly more severe atherosclerotic disease. The researchers attributed this to the higher systemic inflammation burden in patients with PsA.

The study indicated that compared with both a healthy control group and patients matched for vascular risk factors, patients with PsA had a significantly higher cardiovascular risk. This could imply that systemic inflammation could be an independent risk factor for cardiovascular risk.

“Some molecules may be useful, as adjuncts to imaging procedures, as markers of atherosclerotic disease in [patients with] PsA, and could be used for the management of [PsA],” the researchers wrote.


Peluso R, Caso F, Tasso M, et al. Biomarkers of subclinical atherosclerosis in patients with psoriatic arthritis. Open Access Rheumatol. 2019;11:143-156.