title: Cumulative inflammatory burden is independently associated with increased arterial stiffness in patients with psoriatic arthritis: a prospective study.
abstract: BACKGROUND
  The aim of this study was to examine whether the cumulative inflammatory burden is associated with an increase in arterial stiffness in a prospective cohort of psoriatic arthritis (PsA) patients.
  
  
  METHODS
  In total, 72 PsA patients were followed for a median of 6.5 years. Cumulative inflammatory burden was represented by the cumulative averages of repeated measures of erythrocyte sedimentation rate (ca-ESR) and C-reactive protein (ca-CRP). Brachial-ankle pulse wave velocity (PWV) was measured at the last visit. We also included 47 healthy controls for PWV assessment.
  
  
  RESULTS
  PWV was significantly higher in PsA patients compared with healthy controls after adjustment for age, gender and body weight (1466±29 cm/s versus 1323±38 cm/s, P=0.008). PsA patients were divided into two groups based on whether their PWV value is ≥1450 cm/s (High PWV group, N=38) or <1450 cm/s (Low PWV group, N=34). The High PWV group had a significantly higher ca-ESR (29 (19 to 44) versus 18 (10 to 32) mm/1st hour, P=0.005) and ca-CRP (0.7 (0.3 to 1.4) versus 0.4 (0.2 to 0.7) mg/dl, P=0.029). Using regression analysis, high ca-ESR (defined as ≥75th percentile: 37 mm/1st hour) was associated with a higher likelihood of being in the High PWV group (odds ratio (OR): 9.455 (1.939 to 46.093), P=0.005, adjusted for baseline clinical and cardiovascular risk factors; and 9.111 (1.875 to 44.275), P=0.006, adjusted for last visit parameters).
  
  
  CONCLUSIONS
  Cumulative inflammatory burden, as reflected by ca-ESR, was associated with increased arterial stiffness in PsA patients even after adjustment for cardiovascular risk factors, emphasizing the important role of chronic inflammation in accelerating the development of cardiovascular risks in PsA patients.
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. shenjiayun@hotmail.com.
authors.forename: Jiayun
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. qingshang@cuhk.edu.hk.
authors.forename: Qing
authors.initials: Q
authors.lastname: Shang
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. edmundli@cuhk.edu.hk.
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Li
authors.affiliation: Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore, Singapore. katyccc@hotmail.com.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Leung
authors.affiliation: Department of Medicine and Geriatrics, Taipo Hospital, Taipo, Hong Kong, China. kunwl@ha.org.hk.
authors.forename: Emily W
authors.initials: EW
authors.lastname: Kun
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. cathklw@yahoo.com.hk.
authors.forename: Lai-Wa
authors.initials: LW
authors.lastname: Kwok
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. martinli@cuhk.edu.hk.
authors.forename: Martin
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. tena_li@yahoo.com.hk.
authors.forename: Tena K
authors.initials: TK
authors.lastname: Li
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. tracyzhu@cuhk.edu.hk.
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Zhu
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. cmyu@cuhk.edu.hk.
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. lstam@cuhk.edu.hk.
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
mesh_terms: D055109:Ankle Brachial Index; D015535:Arthritis, Psoriatic / Q000150:complications* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D013997:Time Factors; D059289:Vascular Stiffness / Q000502:physiology*