title: Association between psoriasis and coronary calcium score.
abstract: BACKGROUND
  Emerging data suggests that chronic inflammatory disease, such as psoriasis, may be associated to coronary artery disease (CAD).
  
  
  OBJECTIVE
  Analyze the association between psoriasis and subclinical atherosclerosis using coronary calcium score (CAC).
  
  
  METHODS
  We investigated 221 participants with psoriasis and 718 age- and sex-matched controls without prior known CAD. All participants completed a questionnaire and underwent laboratory tests and a CAC exam. Logistic regression models adjusted for Framingham risk score (FRS) and C-reactive protein (hs-CRP) were built. CAC was included in the models as a binary variable with different cut off values.
  
  
  RESULTS
  Body-mass index, race, hypertension, HDL, LDL and hs-CRP were significantly associated with psoriasis presence and severity. Psoriasis severity was significantly associated with CAC (p = 0.04), particularly for very high CAC (>400) (p < 0.01). The OR for severe psoriasis and CAC >400 was 2.45 (95%CI: 1.26-4.75) in unadjusted models. In a model adjusted for the FRS, this association was no longer significant, but a trend was noted (p = 0.09). No significant changes in the association were noted after the inclusion of hs-CRP in the model.
  
  
  CONCLUSIONS
  Psoriasis is associated with higher CAC values, mainly in individuals with severe psoriasis. The current findings also suggest the potential involvement of other mechanisms beyond classical cardiovascular risk factors and inflammation in this association.
authors.affiliation: Division of Internal Medicine, Hospital Universitário, University of São Paulo, Brazil; Center for Clinical and Epidemiologic Research, Hospital Universitário, University of São Paulo, Brazil.
authors.forename: Henrique L
authors.initials: HL
authors.lastname: Staniak
authors.affiliation: Division of Internal Medicine, Hospital Universitário, University of São Paulo, Brazil; Center for Clinical and Epidemiologic Research, Hospital Universitário, University of São Paulo, Brazil.
authors.forename: Márcio Sommer
authors.initials: MS
authors.lastname: Bittencourt
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitário, University of São Paulo, Brazil.
authors.forename: Itamar
authors.initials: I
authors.lastname: de Souza Santos
authors.affiliation: Division of Internal Medicine, Hospital Universitário, University of São Paulo, Brazil; Center for Clinical and Epidemiologic Research, Hospital Universitário, University of São Paulo, Brazil.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Sharovsky
authors.affiliation: Postgraduate Student, University of São Paulo, Brazil.
authors.forename: Cid
authors.initials: C
authors.lastname: Sabbag
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitário, University of São Paulo, Brazil.
authors.forename: Alessandra C
authors.initials: AC
authors.lastname: Goulart
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitário, University of São Paulo, Brazil.
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitário, University of São Paulo, Brazil. Electronic address: isabensenor@hu.com.br.
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Benseñor
mesh_terms: D050197:Atherosclerosis / Q000097:blood / Q000150:complications; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002118:Calcium / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood; D007249:Inflammation; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D015999:Multivariate Analysis; D011565:Psoriasis / Q000097:blood* / Q000150:complications*; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D002097:C-Reactive Protein; D002118:Calcium
keywords: Cardiovascular disease; Cardiovascular risk factors; Coronary artery calcium; Psoriasis; Subclinical atherosclerosis