Psoriatic Arthritis, Rheumatoid Arthritis Carry Increased Risk of Cardiovascular Death

More severe psoriasis associated with clinically significant cardiovascular risk.

Patients with psoriatic arthritis, psoriasis, and rheumatoid arthritis face a higher risk for major cardiovascular events and death, according to the results of a recent study.

Published online last month in the Annals of the Rheumatic Diseases, the multi-institutional study led by researchers at Penn Medicine evaluated primary care records from 1994 to 2010 for adults between 18 and 89 years if age. The study included 8700 psoriatic arthritis patients (PsA), 138,000 psoriasis patients, approximately 42,000 rheumatoid arthritis (RA) patients, and nearly 82,000 controls who were not experiencing any of the conditions.

Just over half of the patients with PsA and RA were prescribed a disease-modifying anti-rheumatic drug (DMARD), while at least 65% of patients with PsA and RA were prescribed non-steroidal anti-inflammatory drugs, compared with 24% of patients with psoriasis and 47% of the control group.

After adjusting for cardiovascular risk factors, the researchers found that patients with PsA were 36% more likely to experience a heart attack than the control group, regardless of whether they were prescribed a DMARD.

“We expected the increased risk of heart disease in these patients,” lead author Alexis Ogdie, MD, MSCE, said in a press release. “Previous studies link whole-body inflammation with premature plaque buildup in the arteries.”

The researchers noted that an increased risk of major adverse cardiovascular events and cardiovascular mortality in patients with more severe psoriasis was similar in scope to RA patients. This surprising finding, the authors added, points to the significance of the link between cardiovascular risk and more severe psoriasis.

On the heels of the findings, the researchers are currently running clinical trials to evaluate if medications used to treat psoriasis, PsA, and RA can improve aortic vascular inflammation that is associated with the conditions.