Background: Psoriatic arthritis (PsA) is a multisystemic inflammatory disorder associated with accelerated atherosclerosis and adverse cardiovascular (CV) events. Previous studies have shown that patients with this condition, especially those with moderate to severe cutaneous involvement, face an even greater CV risk. The Psoriasis Area and Severity Index (PASI) serves as the standard tool for evaluating the degree of cutaneous involvement in these patients. The PREVENT (Predicting Risk of Cardiovascular Disease EVENTS) calculator by the American Heart Association is a new tool that estimates the risk of Atherosclerotic Cardiovascular Disease (ASCVD) and Heart Failure (HF) at 10 and 30 years. CV risk estimation in these patients is imprecise when assessed with existing calculators, leaving an unmet need.

Objectives: Determine the association between Cutaneous Manifestations and CV risk estimated by the PREVENT calculator, in patients with PsA.

Methods: We conducted a cross-sectional and comparative study that included patients with PsA aged 35 to 75 years who met the 2006 CASPAR criteria. Patients with a history of cardiovascular disease, pregnancy, and overlap syndrome were excluded. We calculated the 10- and 30-year risk of ASCVD and HF using the PREVENT calculator. Patients were classified based on their skin involvement as active (PASI > 1) or inactive (PASI ≤ 1), while cardiovascular risk was categorized according to the PREVENT classification: low risk (<5), borderline risk (5 to 7.4), intermediate risk (7.5 to 19.9) and high risk (≥20). The Kolmogorov-Smirnov test was used to determine normality. Statistical tests were performed using the Student’s T-test, Chi-square test, and Mann-Whitney U test, as needed. A p-value ≤ 0.05 was considered statistically significant.

Results: A total of 61 patients were included, the majority of whom were women (Active Skin Involvement n = 34, 55.8% and Inactive Skin Involvement n = 27, 55.5%) with a similar mean age between both groups (52.0 ± 12.0). No differences were observed between the groups in terms of traditional cardiovascular risk factors (Table 1). Most patients were classified as low risk for ASCVD and HF at 10 years, regardless of the presence or absence of cutaneous involvement (72.9% and 62.0%, respectively, p = 0.34). In patients with cutaneous manifestations, disease duration was shorter (4.0 years, p = 0.17), and they showed a higher classification of intermediate risk for ASCVD and HF at 30 years (40.5% in both cases, p = 0.08). No patients were classified as high risk for ASCVD at 10 years; however, 5.4% of patients with active skin involvement were categorized as high risk for HF at 10 years, compared to the group without this involvement, which had no patients in this category (p = 0.20).

Conclusion: Our study did not find an association between cutaneous involvement assessed with PASI and an increased cardiovascular risk estimated using PREVENT in patients with PsA. However, we observed that patients with cutaneous manifestations had a shorter disease duration and a higher classification of high risk for ASCVD and HF at 30 and 10 years, respectively. Therefore, optimal disease management from early stages is recommended in this patient group, incorporating cardiovascular risk factors.

REFERENCES: [1] Svedbom A, Ståhle M. The psoriasis area and severity index is an independent risk factor for cardiovascular events: A prospective register study. J Eur Acad Dermatol Venereol. 2023; 37:1841–7. https://doi.org/10.1111/jdv.19168

[2] Garshick M, Ward N, Krueger J, et al. Cardiovascular Risk in Patients With Psoriasis: JACC Review Topic of the Week. J Am Coll Cardiol. 2021;77(13):1670–80. https://doi.org/10.1016/j.jacc.2021.02.009

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.