title: Subclinical carotid atherosclerosis in patients with psoriatic arthritis.
abstract: OBJECTIVE
  To examine the prevalence of subclinical atherosclerosis in patients with psoriatic arthritis (PsA) compared with healthy controls, and to identify clinical and biologic markers for atherosclerotic disease in this patient population.
  
  
  METHODS
  Subclinical atherosclerosis was defined as the average of intima-media thickness (IMT) measures in the common carotid artery, bifurcation, and internal carotid artery on both sides above the 95th percentile of healthy controls. IMT was measured using carotid ultrasonography in 82 consecutive PsA patients and 82 healthy controls matched on age, sex, and ethnicity. We also ascertained traditional and novel cardiovascular (CV) risk factors, Framingham risk score (FRS), disease severity, treatment, and inflammatory markers in all PsA patients.
  
  
  RESULTS
  No PsA patients had clinically overt CV diseases. After adjusting for traditional CV risk factors, PsA patients had a higher prevalence of subclinical atherosclerosis. PsA patients with subclinical atherosclerosis had significantly increased sugar, total triglyceride levels, total cholesterol/high-density cholesterol, white cell count, and patients' global assessment score compared with those without subclinical atherosclerosis. Using logistic regression analysis, independent explanatory variables associated with subclinical atherosclerosis in PsA included increased sugar and total triglyceride levels. The FRS was similar in PsA patients with or without subclinical atherosclerosis. Twenty-six (35%) of 74 patients had subclinical atherosclerosis despite having a low CV risk.
  
  
  CONCLUSIONS
  PsA is associated with subclinical atherosclerosis after adjusting for traditional CV risk factors. Independent explanatory variables associated with subclinical atherosclerosis in PsA included increased sugar and total triglyceride levels. Carotid IMT can identify PsA patients with subclinical atherosclerosis who may benefit from early intervention.
authors.affiliation: The Prince of Wales Hospital and The Chinese University of Hong Kong, Hong Kong, China. tamls_813@yahoo.com
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
authors.forename: Qing
authors.initials: Q
authors.lastname: Shang
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Li
authors.forename: Brian
authors.initials: B
authors.lastname: Tomlinson
authors.forename: Tanya T W
authors.initials: TT
authors.lastname: Chu
authors.forename: Martin
authors.initials: M
authors.lastname: Li
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Leung
authors.forename: Lai-Wa
authors.initials: LW
authors.lastname: Kwok
authors.forename: Kong-Chiu
authors.initials: KC
authors.lastname: Wong
authors.forename: Tena K
authors.initials: TK
authors.lastname: Li
authors.forename: Tracey
authors.initials: T
authors.lastname: Yu
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Zhu
authors.forename: Emily W
authors.initials: EW
authors.lastname: Kun
authors.forename: Gabriel W
authors.initials: GW
authors.lastname: Yip
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu