title: Prevalence and extent of subclinical atherosclerosis in patients with psoriasis.
abstract: OBJECTIVE
  Patients with psoriasis are prone to premature atherosclerosis and increased risk of cardiovascular disease events. However, the prevalence and extent of atherosclerosis in patients with psoriasis are unknown.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  The prevalence and extent of coronary and carotid atherosclerosis were compared in 70 patients with psoriasis (46 ± 9 years, 71% male) without known cardiovascular disease or joint involvement and 51 age- and gender-matched healthy control subjects (45 ± 7 years, 71% male). Systemic inflammation was assessed by the level of high-sensitivity C-reactive protein (hs-CRP). Coronary atherosclerosis was determined by the coronary calcification score (CCS) measured by multi-detector computed tomography. Carotid atherosclerosis was assessed by high-resolution ultrasound-derived carotid intima-media thickness (cIMT).
  
  
  RESULTS
  Patients with psoriasis had a higher prevalence of coronary atherosclerosis (CCS > 0; 28.6% vs. 3.9%, P < 0.01), and a higher degree of coronary atherosclerosis estimated by the mean CCS (67.4 ± 349.2 vs. 0.5 ± 3.0, P < 0.05) compared with controls. Similarly, cIMT was significantly greater in patients with psoriasis than in control subjects (0.73 ± 0.11 mm vs. 0.67 ± 0.08 mm, P < 0.01). Multiple logistic regression revealed that psoriasis [odd ratio (OR): 10.54, 95% confidence interval (CI) 1.89-58.67, P < 0.01] and serum total cholesterol level (OR 2.10, 95% CI 1.01-4.37) were associated with the presence of coronary atherosclerosis (CCS > 0). By contrast, only age was independently associated with increased cIMT. Amongst participants with no traditional cardiovascular disease risk factors, hs-CRP level was higher in patients with psoriasis than in controls.
  
  
  CONCLUSIONS
  The present results demonstrate early-onset, diffuse arterial atherosclerosis in coronary and carotid arteries in patients with psoriasis, but not in age- and gender-matched control subjects. Low-grade inflammation could explain the presence of premature atherosclerosis in patients with psoriasis.
authors.affiliation: Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China. khkyiu@hotmail.com
authors.forename: K-H
authors.initials: KH
authors.lastname: Yiu
authors.forename: C-K
authors.initials: CK
authors.lastname: Yeung
authors.forename: C-T
authors.initials: CT
authors.lastname: Zhao
authors.forename: J C
authors.initials: JC
authors.lastname: Chan
authors.forename: C-W
authors.initials: CW
authors.lastname: Siu
authors.forename: S
authors.initials: S
authors.lastname: Tam
authors.forename: C-S
authors.initials: CS
authors.lastname: Wong
authors.forename: G H
authors.initials: GH
authors.lastname: Yan
authors.forename: W S
authors.initials: WS
authors.lastname: Yue
authors.forename: P-L
authors.initials: PL
authors.lastname: Khong
authors.forename: H H
authors.initials: HH
authors.lastname: Chan
authors.forename: H-F
authors.initials: HF
authors.lastname: Tse
mesh_terms: D000293:Adolescent; D000328:Adult; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015995:Prevalence; D011565:Psoriasis / Q000453:epidemiology*; D014463:Ultrasonography; D055815:Young Adult