Joshi AA, et al. - Given that inflammation is critical to atherosclerosis and psoriasis is a chronic inflammatory disease associated with early cardiovascular events, researchers evaluated the link between aortic vascular inflammation (VI) and coronary artery disease (CAD) indices—including total plaque burden (TB), noncalcified coronary plaque burden (NCB), luminal stenosis, and high-risk plaques (HRP) prevalence—in psoriasis. The authors noted an association of aortic VI with broad CAD indices, suggesting that aortic VI may be a surrogate for early CAD.

Methods

• Researchers performed a cross-sectional cohort study at the National Institutes of Health, between January 1, 2013, and May 31, 2017.
• Surrounding outpatient dermatology practices were searched and 215 consecutive patients with psoriasis were recruited.
• Aortic VI was evaluated by performing ¹⁸F-FDG PET/CT on all patients, and coronary computed tomography angiography was used to characterize CAD in 190 of 215 patients.
• Data analysis was carried out in March 2018.
• The investigators assessed TB and NCB as the primary outcome; luminal stenosis and HRP were included as secondary outcomes.

Results

• They observed increased TB, as well as a higher prevalence of luminal stenosis and HRP, in patients with increased aortic VI among all patients with psoriasis (mean [SD] age, 50.4 [12.6] years; 126 men [59%]).
• They noted that the primary driver of aortic VI and TB association was NCB, whereas the driver of the aortic VI and HRP association was low-attenuation plaque.
• Significance of all associations of aortic VI was maintained even after adjustment for cardiovascular risk factors (aortic VI and TB, NCB, luminal stenosis, and HRP).
• According to findings, there was no link between aortic VI and dense-calcified coronary plaque burden.