title: Ischemic cardiovascular involvement in psoriasis: a systematic review.
abstract: Epidemiologic studies demonstrate that psoriasis is associated with shorter life expectancy, most frequently attributable to cardiovascular (CV) events. Although increased prevalence and incidence of CV risk factors for atherosclerosis have been reported in psoriatic patients, psoriasis likely plays an independent role in the increased cardiovascular risk, presumably linked to the chronic systemic inflammatory state. Consistently, preliminary investigations suggest that anti-inflammatory therapies may improve early subclinical vascular alterations and reduce cardiovascular morbidity and mortality. This review will focus on ischemic CV involvement in psoriatic patients, summarizing the prevalence and incidence of CV risk factors and CV events, as well as evidence on mechanisms of premature atherosclerosis and on effects of systemic anti-inflammatory therapies on CV risk profile. We performed a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and evaluated the quality of studies comparing drug treatments using Detsky score. Our review documented that psoriatic patients are at increased CV risk, related to raised prevalence and incidence of CV risk factor and to inflammatory status. However, available literature lacks of studies that establish appropriate targets for CV risk factors and assess the clinical value of screening for subclinical organ damage and the impact of disease-modifying therapies on CV risk profile in psoriatic patients. Awareness of raised CV risk in psoriatic patients should foster further research aimed at elucidating these aspects.
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Mosca
authors.affiliation: SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Gargiulo
authors.affiliation: Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Balato
authors.affiliation: Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Di Costanzo
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Parente
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Paolillo
authors.affiliation: Department of Clinical Medicine and Surgery, Section of Dermatology, "Federico II" University, Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ayala
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.affiliation: Department of Cardiovascular Medicine, Policlinico A. Gemelli, "Catholic University of the Sacred Heart", Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
authors.affiliation: Department of Advanced Biomedical Sciences, Section of Cardiology, "Federico II" University, Naples, Italy. Electronic address: fpperron@unina.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Perrone-Filardi
mesh_terms: D000893:Anti-Inflammatory Agents; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D002986:Clinical Trials as Topic / Q000379:methods; D006801:Humans; D011565:Psoriasis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D000893:Anti-Inflammatory Agents
keywords: Atherosclerosis; Cardiovascular risk; Coronary artery disease; Inflammation; Psoriasis