Background: Patients with psoriatic arthritis (PsA) have a higher prevalence of classical vascular risk factors (CVRF) and early atherosclerosis determined by chronic inflammation.

Objectives: To study the evolution over time of different vascular damage evaluation measures in patients with PsA and investigate the factors related to these changes.

Methods: Pre-post longitudinal study with analytical components. PsA patients with peripheral joint involvement were included, those with glomerular filtration rate (GF-MDRD) <60 mg/dl, previous event and/or diabetes mellitus were excluded. Demographic (sex, age), anthropometric [body mass index (BMI), abdominal circumference (AC)], clinical (duration of the disease, pattern of involvement, current treatment, CVRF, vascular events) and analytical variables (atherogenic index, GF-MDRD, fibrinogen, glycosylated hemoglobin, CRP, ESR, ultrasensitive CRP, Apolipoprotein A1, apolipoprotein B, lipoprotein A, microalbuminuria, uric acid and 25-hydroxyvitamin D) were collected. Disease activity was assessed using DAPSA index, and quality of life with HAQ questionnaire. Other variables were collected retrospectively from the clinical history. Basal vascular risk was estimated through SCORE tool. Extracranial carotid artery was explored with an Esaote MyLab70XVG ultrasound with linear probe (7-12mHz) and an automated program that measures intima media thickness (IMT) by radiofrequency (“Quality intima media thickness in real-time), and the presence of atheroma plaques was evaluated following Mannheim consensus. The vascular study was repeated in a period ≥24 months. The appearance and/or increase in the number of atheroma plaques and/or the appearance of significant stenosis compared to baseline were defined as vascular progression. Statistical analysis was performed using SPSS 17.0 program.

Results: 108 patients were included, 59.3% of them were women and the mean age was 61.9 (SD 10.9) years. Mean disease duration was 14 (SD 6.5) years. The mean DAPSA and HAQ values were 25.1 (SD 13.6) and 0.5 (SD 0.6), respectively. 21.3% of patients received glucocorticoids, 56.5% NSAIDs, 97.2% DMARDs and 45.4% biological drugs. Mean BMI was 28.2 (SD 7.8) kg/m ² and mean AC was 97.1 (SD 14.6) cm. 35.5% of patients were smokers, 23.1% hypertensive (33.3% diuretics, 8.3% beta-blockers, 66.7% ARA2, 20.8%% ACEI, 20.8% on calcium channel blockers and 25.9% dyslipidemic [most of them (92.6%) on statins]. Mean SCORE was 1.45 (SD 1.6). Baseline, 31.5% of patients had atheromatous plaques and their mean plaque count was 1.45 (SD 1.6). During the follow-up period, 34,3% of patients exibited vascular progression in the form of new atheroma plaques or increase in their size. Two patients developed vascular events (1 cardiac and 1 peripheral arterial) and only one death was recorded. The factors related with progression of vascular damage were: male gender (p=0.042), tobacco exposure (p=0,033), absence of taking NSAIDs (p=0,016), HLAB27-(p=0,044), lower AC (p=0,028) and BMI (p=0,042), as well as decreased albumin (p=0,03) and GF-MDRD (p=0,015) levels; the last three factors determined vascular progression in the binary logistic regression.

Conclusion: Progression of vascular damage is mainly related to CVRF in patients with PsA, therefore it is essential to intervene on CVRF early.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.