title: Increased prevalence of coronary plaque in patients with psoriatic arthritis without prior diagnosis of coronary artery disease.
abstract: OBJECTIVE
  To evaluate coronary atherosclerosis in patients with psoriatic arthritis (PsA) and control subjects using coronary CT angiography (CCTA).
  
  
  METHODS
  Ninety consecutive patients with PsA (male: 56(62.2%); 50.3±11.1 years) were recruited. 240 controls (male: 137(57.1%); 49.6±10.7 years) without known cardiovascular (CV) diseases who underwent CCTA due to chest pain and/or multiple CV risk factors were recruited for comparison.
  
  
  RESULTS
  Patients with PsA and controls were matched in age, gender and traditional CV risk factors (all p>0.2). The prevalence of overall plaque (54(60%)/84(35%), p<0.001), calcified plaque (CP) (29(32%)/40(17%), p=0.002), mixed plaque (MP) (20(22%)/18(8%), p<0.001), non-calcified plaque (NCP) (39(43%)/53(22%), p<0.001) and combined MP/NCP (46(51%)/62(26%), p<0.001) were all significantly higher in patients with PsA. Three-vessel disease was diagnosed in 12(13%) patients with PsA and 7(3%) controls (p<0.001), while obstructive plaques (>50% stenosis) were observed in 8(9%) patients with PsA and 7(3%) controls (p=0.033). After adjusting for traditional CV risk factors, PsA remained an independent explanatory variable for all types of coronary plaques (OR: 2.730 to 4.064, all p<0.001). PsA was also an independent explanatory variable for three-vessel disease (OR: 10.798, p<0.001) and obstructive plaque (3.939, p=0.024). In patients with PsA, disease duration was the only disease-specific characteristic associated with more vulnerable plaques (MP/NCP) in multivariate analysis (1.063, p=0.031). The other independent explanatory variables were age ≥55 years (5.636, p=0.005) and male gender (8.197, p=0.001).
  
  
  CONCLUSIONS
  Patients with PsA have increased prevalence, burden and severity of coronary atherosclerosis as documented by CCTA. Longer disease duration was independently associated with the presence of vulnerable MP/NCP plaques in patients with PsA.
  
  
  BACKGROUND
  NCT02232321.
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Jiayun
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Ka-Tak
authors.initials: KT
authors.lastname: Wong
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Isaac T
authors.initials: IT
authors.lastname: Cheng
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
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, Hong Kong, Hong Kong.
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Li
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Wong
authors.affiliation: Department of Medicine and Geriatrics, Tai Po Hospital, Hong Kong, Hong Kong.
authors.forename: Emily W
authors.initials: EW
authors.lastname: Kun
authors.affiliation: Department of Medicine and Geriatrics, Tai Po Hospital, Hong Kong, Hong Kong.
authors.forename: Mei Yan
authors.initials: MY
authors.lastname: Law
authors.affiliation: Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, Hong Kong.
authors.forename: Ronald
authors.initials: R
authors.lastname: Yip
authors.affiliation: Department of Medicine, Tseung Kwan O Hospital, Hong Kong, Hong Kong.
authors.forename: Isaac
authors.initials: I
authors.lastname: Yim
authors.affiliation: Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, Hong Kong.
authors.forename: Shirley
authors.initials: S
authors.lastname: Ying
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
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, Hong Kong, Hong Kong.
authors.forename: Tena K
authors.initials: TK
authors.lastname: Li
authors.affiliation: Department of Chemical Pathology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Chun-Kwok
authors.initials: CK
authors.lastname: Wong
authors.affiliation: Bone Quality and Health Center of the Department of Orthopedics & Traumatology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Zhu
authors.affiliation: Division of Biostatistics, The Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Jack Jock-Wai
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Mimi
authors.initials: M
authors.lastname: Chang
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Alex Pui-Wai
authors.initials: AP
authors.lastname: Lee
authors.affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000453:epidemiology*; D015897:Comorbidity; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic / Q000453:epidemiology*; D015995:Prevalence; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*
keywords: Atherosclerosis; Cardiovascular Disease; Psoriatic Arthritis