Prevalence of cardiovascular comorbidities in psoriatic arthritis: relationship with clinical phenotype and treatment in a real-life study.

Abstract

Introduction: The relationship between the phenotype and treatment of psoriatic arthritis (PsA) and the increased prevalence of cardiovascular comorbidities is not well studied.

Objective: The aim of this study was to assess the prevalence of cardiovascular comorbidities in relation to the clinical phenotype and treatment of PsA.

Methods: This was a cross‑sectional, real‑life study. Demographic and clinical data were recorded in patients with PsA. The relationships between clinical phenotypes (axial, oligoarthritis, polyarthritis, and mixed), cardiovascular risk factors, comorbidities, and treatment were analyzed.

Results: Among the 267 patients studied, no differences were found in the prevalence of cardiovascular risk factors or comorbidities in relation to the clinical phenotypes of PsA. However, the patients with oligoarthritis more frequently had hypertension (38.8% vs 22%; P = 0.01). The patients with any cardiovascular disease were more often receiving treatment with glucocorticosteroids (17.9% vs 4.8%; P = 0.001) as well as were exposed to them in the past (22.6% vs 13%; P = 0.02). As many as 83.3% of the patients currently on nonsteroidal anti‑inflammatory drugs (NSAIDs) had heart failure (HF), while among those without HF, NSAIDs were taken by 35.3% (P = 0.03). A total of 15.4% of the patients were diagnosed with dyslipidemia but low‑density lipoprotein cholesterol level above 3 mmol/l was detected in 36.6% of the participants. A multivariable logistic regression analysis identified the current use of glucocorticosteroids and oligoarthritis as predictive factors for cardiovascular comorbidities.

Conclusion: The use of glucocorticoids and NSAIDs is associated with an increased prevalence of cardiovascular comorbidities in patients with PsA and should be avoided. Oligoarthritis and current use of glucocorticosteroids are predictors of cardiovascular comorbidities. Hyperlipidemia remains underrecognized in patients with PsA in a real‑world context.