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    BTS Announce Their Big Return and Yes, They Already Have Some Major Plans in the Works – Yahoo

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    BTS Announce Their Big Return and Yes, They Already Have Some Major Plans in the Works – Yahoo

    BTS Announce Their Big Return and Yes, They Already Have Some Major Plans in the Works – Yahoo

    Nantucket Dance Festival opens July 8 – The Inquirer and Mirror

    Nantucket Dance Festival Launches with Thrilling Performances Beginning July 8

    A Secret Society, Ritualistic Killings, and a Century-Old Curse Netflix and YRF Entertainment’s ‘Mandala Murders’ Premieres July 25 – About Netflix

    A Secret Society, Ritualistic Killings, and a Century-Old Curse: Dive into the Chilling World of ‘Mandala Murders’ Premiering July 25

    Susquehanna Raises Penn Entertainment Inc. (PENN) Price Target. – Yahoo Finance

    Susquehanna Raises Price Target for Penn Entertainment Inc. (PENN)

    George Lopez is coming to Spokane – KXLY.com

    George Lopez is coming to Spokane – KXLY.com

    Netflix unveils Dallas immersive venue for fans of hit shows like ‘Squid Game,’ ‘Stranger Things’ – Houston Chronicle

    Step Inside Netflix’s New Dallas Immersive Experience Featuring Hits Like ‘Squid Game’ and ‘Stranger Things

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    Cracking the Code: Why China’s Economic Challenges Aren’t Shaking Markets, Unlike America’s” – Bloomberg

    Trump’s Narrow Window to Spread the Truth About Harris

    Trump’s Narrow Window to Spread the Truth About Harris

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

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    Inspira Technologies Secures Landmark $22.5M Deal: Major Revenue Breakthrough After FDA Clearance – Stock Titan

    Inspira Technologies Secures Landmark $22.5M Deal: Major Revenue Breakthrough After FDA Clearance – Stock Titan

    Meiwu Technology Company Limited and Shenzhen Zhinuo – GlobeNewswire

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Link Between Psoriasis, Heart Disease Tracks to Coronary Microvascular Dysfunction

September 20, 2023
in Health
Link Between Psoriasis, Heart Disease Tracks to Coronary Microvascular Dysfunction
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Almost a third of patients with severe psoriasis had echocardiographic evidence of asymptomatic coronary microvascular dysfunction (CMD), a prospective study showed.

Doppler echocardiography showed that 31.5% of 448 patients with psoriasis had CMD. Every 1-point increase in the Psoriasis Area and Severity Index (PASI) score and 1-year increase in psoriasis duration correlated with a 5% to 6% increase in the risk of CMD.

The findings provide a possible mechanistic explanation for the substantial existing body of evidence linking psoriasis to cardiovascular disease, reported Stefano Piaserico, MD, PhD, of the University of Padua in Italy, and co-authors in the Journal of Investigative Dermatology.

“These findings are consistent with the view of systemic inflammation as a key contributor to atherosclerosis and suggest that the coronary microcirculation may represent an extracutaneous site directly involved in the immune-mediated injury characteristic of psoriasis,” the authors concluded. “Accordingly, we should diagnose and actively search for microvascular dysfunction in patients with psoriasis, as this population is at particularly high risk.”

“This assessment might have particular value in the diagnosis, stratification, and treatment of CV [cardiovascular] risk in psoriasis,” they added. “Because the dysfunction is correlated to the activity and length of psoriasis and is largely independent of traditional CV risk factors, studies on CFR [coronary flow reserve] may also be useful for monitoring vascular function during therapy of psoriasis, which may, hopefully, be a surrogate for decreasing the risk of subsequent CV events.”

Several studies have shown that patients with psoriasis have an increased prevalence of CV morbidity and mortality, resulting from accelerated atherosclerosis and premature coronary artery disease. The excess CV risk has been attributed to psoriasis-induced inflammation, which might affect atherosclerotic plaque formation and coronary microvascular function.

Despite the well-established association between psoriasis and CV risk, patients with psoriasis may be undertreated for CV risk factors. One recent study showed that a majority of patients with psoriasis would welcome input from their dermatologist about CV risk. A majority of dermatologists surveyed for the study said it would be feasible to assess CV risk and lipid levels in patients with psoriasis, but only about a third agreed with a statement about prescribing statins for primary prevention.

Another previous study showed that most patients with psoriasis had been evaluated for CV risk factors, but 20% to 40% had untreated diabetes, hypertension, or hyperlipidemia. A substantial proportion of patients with treated CV risk factors did not achieve guideline-recommended goals.

Understanding about the underlying mechanisms of cardiovascular disease in psoriasis has remained limited, Piaserico and co-authors noted. More than a decade ago, they showed a higher prevalence of reduced CFR in patients with psoriasis as compared with the general population. Subsequently, several other studies confirmed the observation. However, most of the confirmatory studies were limited by small numbers of patients.

Continuing their search for a mechanistic explanation, the authors enrolled 503 patients with psoriasis, 448 of whom had complete information on CFR and psoriasis status and were included in data analysis. The cohort had a median psoriasis duration of 15.2 years, mean baseline PASI of 12, and three-fourths had CFR assessment by echocardiography before beginning treatment.

The results showed that 141 of the 448 patients had CMD, defined as a CFR ≤2.5. The total included 12.9% with a CFR ≤2, and 5.1% with a CFR ≤1.5. Patients with CMD at enrollment were older, had a higher body mass index, and had higher prevalences of hypertension and psoriatic arthritis.

Lower CFR correlated significantly with higher PASI scores (P=0.0002) and longer duration from psoriasis diagnosis (P=0.01). The cohort had a median CFR of 3.02 for patients with a PASI
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Copyright for syndicated content belongs to the linked Source : MedPageToday – https://www.medpagetoday.com/dermatology/psoriasis/106408

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