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AB0428 (2024)
ASSOCIATIONS BETWEEN DIAGNOSIS DELAY, DISEASE ACTIVITY AND CARDIOVASCULAR RISK IN PSORIATIC ARTHRITIS
Keywords: Atherosclerosis, Best practices, Cardiovascular diseases
A. L. Guajardo-Aldaco1, M. F. Elizondo-Benitez1, D. A. Galarza-Delgado1, I. J. Colunga-Pedraza1, J. R. Azpiri-Lopez2, J. A. Cardenas-de la Garza1, R. I. Arvizu-Rivera1, V. González-González1
1Hospital Universitario “Dr. Jose Eleuterio Gonzalez”, Universidad Autonoma de Nuevo Leon, Rheumatology Department, Monterrey, Mexico
2Hospital Universitario “Dr. Jose Eleuterio Gonzalez”, Universidad Autonoma de Nuevo Leon, Cardiology Department, Monterrey, Mexico

Background: Psoriatic Arthritis (PsA) diagnosis and treatment is commonly delayed, or even missed due to the manifold of clinical presentations that patients often experience. Diagnosis delay is associated with a higher disease activity and a poorer functional outcome on PsA patients. The effect of diagnosis delay on cardiovascular (CV) risk has not been determined.


Objectives: To compare disease activity, CV risk, and prevalence of carotid plaque (CP) and increased carotid intima-media thickness (cIMT) between patients with a diagnosis delay lower or higher than one year.


Methods: We conducted an observational, comparative, and cross-sectional study on patients who fulfilled the 2006 Classification Criteria for Psoriatic Arthritis (CASPAR). Disease Activity was assessed through clinical history and blood tests. Patients´ CV risk was estimated with six different calculators: Framingham Risk Score-BMI (FRS-BMI), Atherosclerotic Cardiovascular Disease (ASCVD), QRISK3, SCORE, and the World Health Organization CV risk non-laboratory-based charts (WHO-BMI). The presence of cIMT and CP was evaluated by Carotid B- mode ultrasonography. Descriptive analyses were performed with frequencies (%), mean (± SD) and median (q25-q75), and comparisons with Chi square, Student ́s t and Mann-Whitney U test. We considered p<0.05 significative.


Results: A total of 63 patients were recruited. Patients who got a diagnosis after one year of the symptoms’ onset had significant higher disease activity measured by Disease Activity in Psoriatic Arthritis (DAPSA) score [21.52 ±16.67 vs. 12.11 ±10.58; p=0.009], by 28-Joint Disease Activity Score C-Reactive Protein (DAS28-RCP) [2.887 ±1.168 vs. 2.175 ±1.025; p=0.012], and by 28-Joint Disease Activity Score Erythrocyte Sedimentation Rate (DAS28-ESR) [4.453 ± 1.474 vs. 3.247 ± 1.284; p=0.001]. Patients with a diagnosis delay higher than one year also reported a higher pain Numerical Rating Scale (NRS) than patients without diagnosis delay [3.5 (0-10.00) vs. 3.00 (0-10.00; p=0.018]. There were no significant differences in Psoriatic Area Severity scale (PASI) or Nail Psoriasis Severity Index (NAPSI). There were no significant differences in CP and c-IMT prevalence between both groups. Patients with diagnosis delay higher than one year had significant higher risk in WHO-BMI CV risk calculator [6.88 (1.0-18.0) vs. 4.59 (1.0-13.0); p=0.034], with no significant differences between the other evaluated calculators. (Table 1)


Conclusion: Patients with a diagnostic delay above one year have a higher disease activity than those diagnosed in a shorter period, without significant differences in prevalence for CP or cIMT. Early diagnosis and intervention are imperative to improve the patient´s outcome.

Clinical and Sociodemographic Characteristics

Diagnosis in less than one year n= 35 Diagnosis in more than one year n= 28 p -value
Age, Mean ±SD 53.47 ±11.31 56.75 ±10.77 NS
Female, n (%) 18 (51.42) 17 (60.71) NS
Das28-CRP, Mean ±SD 2.175 ±1.025 2.887 ±1.168 0.012
Das28-ECR, Mean ±SD 3.247 ±1.284 4.453 ±1.474 0.001
NRS, Median (q25-q75) 3.00 (0-10.00) 3.5 (0-10.00) NS
PASI, Median (q25-q75) 0.3 (0.00-11.8) 1.00 (0.00-10.20) NS
NAPSI, Median (q25-q75) 0.00 (0.00-65.0) 1.00 (0.00-68.0) NS
DAPSA, Mean ±SD 12.11 ±10.58 21.52 ±16.67 0.009
CP, n (%) 16 (45.71) 11 (39.28) NS
Increased cIMT n (%) 6 (17.14) 4 (14.28) NS
WHO-BMI, Median (q25-q75) 4.59 (1.0-13.0) 6.88 (1.0-18.0) 0.034
FRS-BMI, Mean ±SD 15.88 ±14.95 23.34 ±21.35 NS
ASCVD, Median (q25-q75) 4.45 (0.70-33.20) 12.050 (0.3-56.70) NS
QRISK3, Median ±SD 5.20 (0.30-34.00) 9.35 (0.60-39.20) NS
SCORE, Median (q25-q75) 1.00 (0.00-12.00) 2.00 (0.00-11.00) NS
DAS28-CRP, 28-joint Disease Activity Score C-reactive protein; Das28-ECR, 28-joint Disease Activity Score Erythrocyte Sedimentation Rate; NRS, Number Rating Scale; PASI, Psoriasis Area Severity Index; NAPSI, Nail Psoriasis Severity Index; DAPSA, Disease Activity in Psoriatic Arthritis, CP, Carotid Plaque, WHO-BMI, World Health Organization Body Mass Index; FRS-BMI, Framingham Risk Score Body Mass Index; ASCVD, Atherosclerosis Cardiovascular Disease Calculator; SD, Standard Deviation

REFERENCES: NIL.


Acknowledgements: NIL.


Disclosure of Interests: None declared.


DOI: 10.1136/annrheumdis-2024-eular.447
Keywords: Atherosclerosis, Best practices, Cardiovascular diseases
Citation: , volume 83, supplement 1, year 2024, page 1468
Session: Psoriatic arthritis (Publication Only)