Exploring the association between psoriasis and subclinical atherosclerosis defined by carotid intima-media thickness (CIMT) in patients with psoriasis vulgaris: a systematic review and meta-analysis.
Maryam Yousefi, Pouyan Shakeri, Azin Tahvildari, Hossein Salehi Omran, Sara Sharifi, Mohammad A Shafiee
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Abstract
Background: Psoriasis is a chronic inflammatory condition that increases the risk of vascular issues, ranging from mild artery damage to severe events such as heart attacks and strokes. This systematic review and meta-analysis aimed to evaluate the relationship between psoriasis and carotid intima-media thickness (CIMT), a marker of subclinical atherosclerosis.
Methods: A comprehensive search of Embase, PubMed/Medline, Scopus, and CINAHL via EBSCO was conducted up until June 2023 using the terms "Atherosclerosis AND Psoriasis." Studies measuring CIMT to assess atherosclerosis in psoriasis patients were included. A meta-analysis and subgroup analysis were performed to calculate the overall mean difference in CIMT between psoriasis patients and control groups. Studies published between 2009 and 2023 were reviewed, including 28 case-control, 18 cross-sectional, and two prospective cohort studies.
Results: The total sample size was 15,914 participants, with individual study sizes ranging from 32 to 8271. Of the included studies, 44 revealed a significant association between psoriasis and CIMT, suggesting a higher risk of subclinical atherosclerosis in psoriasis patients. The meta-analysis found that psoriasis patients had a CIMT 0.17 mm higher than the control group (95% CI 0.12- 0.22). However, six studies did not show a statistically significant mean difference.
Conclusions: This study emphasizes the importance of assessing cardiovascular risk in psoriasis patients, particularly those with moderate-to-severe disease. It highlights the need for tailored interventions to manage the increased risk of atherosclerosis in this population.
背景：牛皮癣是一种慢性炎症性疾病，可增加血管问题的风险，从轻微的动脉损伤到严重的事件，如心脏病发作和中风。本系统综述和荟萃分析旨在评估银屑病与颈动脉内膜-中膜厚度（CIMT）之间的关系，CIMT是亚临床动脉粥样硬化的标志。方法：通过EBSCO对Embase、PubMed/Medline、Scopus和CINAHL进行综合检索，检索词为“动脉粥样硬化和牛皮癣”，检索截止至2023年6月。通过测量CIMT来评估银屑病患者动脉粥样硬化的研究被纳入。进行荟萃分析和亚组分析，计算银屑病患者和对照组之间CIMT的总体平均差异。我们回顾了2009年至2023年间发表的研究，包括28项病例对照研究、18项横断面研究和2项前瞻性队列研究。结果：总样本量为15,914名参与者，个体研究规模从32到8271不等。在纳入的研究中，有44项揭示了银屑病与CIMT之间的显著关联，表明银屑病患者发生亚临床动脉粥样硬化的风险更高。荟萃分析发现，银屑病患者的CIMT比对照组高0.17 mm （95% CI 0.12- 0.22）。然而，6项研究没有显示统计学上显著的平均差异。结论：本研究强调了评估银屑病患者心血管风险的重要性，特别是那些中度至重度疾病的患者。它强调了有必要采取针对性的干预措施来控制这一人群中动脉粥样硬化风险的增加。
期刊介绍：
The Irish Journal of Medical Science is the official organ of the Royal Academy of Medicine in Ireland. Established in 1832, this quarterly journal is a contribution to medical science and an ideal forum for the younger medical/scientific professional to enter world literature and an ideal launching platform now, as in the past, for many a young research worker.
The primary role of both the Academy and IJMS is that of providing a forum for the exchange of scientific information and to promote academic discussion, so essential to scientific progress.
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