Turk Kardiyol Dern Ars. 2012; 40(7): 574-580 | DOI: 10.5543/tkda.2012.54920

Determination of subclinical atherosclerosis in plaque type Psoriasis patients without traditional risk factors for atherosclerosis.

Emre Refik Altekin¹, Serkan Koc², Mustafa Serkan Karakaş³, Atakan Yanıkoğlu¹, İbrahim Başarıcı¹, İbrahim Demir¹, Erkan Alpsoy^4
1Department of Cardiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
²Department of Cardiology, Agri State Hospital, Agri, Turkey
³Department of Cardiology, Nigde State Hospital, Nigde, Turkey
⁴Department of Dermatology and Venorology, Akdeniz University Faculty of Medicine, Antalya, Turkey

OBJECTIVES
Systemic inflammation plays an important role in the pathogenesis of atherosclerosis in psoriasis patients. Therefore, persistent skin inflammation in psoriasis patients may contribute to the development of premature atherosclerosis, as it occurs in rheumatoid arthritis and systemic lupus erythematosus. We aimed to evaluate the relationship between subclinical atherosclerosis and psoriasis by using pulse wave velocity (PWV) and the measurement of carotid intima media thickness (CIMT) in psoriatic patients.

STUDY DESIGN
Fifty-seven plaque-type psoriasis patients (31 males, 26 females; mean age 41±10.8 years) and 60 healthy individuals (32 males, 28 females; mean age 40±9.4 years) were included. Atherosclerotic risk factors were excluded in both of the groups. Demographic, bio-chemical data, psoriasis area and severity index (PASI) score of the psoriasis group, and disease duration were recorded. Carotid-femoral artery PWV and CIMT values were compared.

RESULTS
PWV, and the maximum and average CIMT values of psoriasis patients were higher than those of the healthy group (PWV: 7.04±1.1 m/sn vs. 6.03±0.61 m/sn, p<0.001; maximum CIMT: 0.86±0.09 mm vs. 0.77±0.06 mm, p<0.001; mean CIMT: 0.73±0.09 mm vs. 0.66±0.06 mm p<0.001, respectively). Although there was no difference in the lipid levels of the groups, total/HDL cholesterol (4.40±1.26 vs. 3.88±1.18, p=0.02, respectively), and LDL/HDL cholesterol ratios (2.78±0.98 vs. 2.32±0.92, p=0.01, respectively) of the psoriasis group were higher than those of the healthy group. A positive correlation was observed between PASI and the PWV (r=0.417, p=0.001).

CONCLUSION
Despite the nonexistence of atherosclerotic risk factors, the risk of development of atherosclerosis is higher in psoriasis patients compared to healthy individuals. In addition to damage of the artery wall caused by systemic inflammation, lipid metabolism disorders may contribute to the development of atherosclerosis in these patients.

Keywords: Atherosclerosis/epidemiology, carotid arteries/pathology/ultrasonography, C-Reactive Protein, lipid metabolism disorders; platelet activation; psoriasis/blood/epidemiology; pulse; risk factors

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