Improvement in Psoriasis skin Disease Severity is Associated with Reduction of Coronary Plaque Burden

Abstract

Background: Psoriasis (PSO), a chronic inflammatory disease associated with increased cardiovascular (CV) risk, provides a clinical human model to study inflammatory atherogenesis. While PSO severity is associated with in vivo vascular disease and future CV risk, the longitudinal impact of PSO severity on coronary disease progression is unknown. We hypothesized that an improvement in PSO severity may lead to a reduction in coronary plaque burden by coronary CT angiography (CCTA). Method(s): Consecutively recruited PSO patients (N=50) underwent CCTA (320 detector row, Toshiba) and cardiometabolic profiling at baseline and 1-year follow-up. Total (TB) and non-calcified (NCB) coronary plaque burden were quantified using QAngio (Medis, Netherlands). PSO severity was measured by PSO area severity index (PASI). The longitudinal change in coronary plaque burden was analyzed with unadjusted and adjusted regression. Result(s): The cohort had a low Framingham Risk Score and mild to moderate PSO. Patients whose PASI improved (DELTAPASI -27%; p<0.001) (N=33) had significant improvement in TB (beta=0.40, p = 0.003) and NCB (beta=0.49, p < 0.001) (Table 1) beyond adjustment for traditional CV risk factors, BMI, statins, & systemic/biologic PSO therapy. Conclusion(s): Improvement in PSO severity was associated with improvement in coronary plaque burden by CCTA. Our study suggests that a reduction in skin inflammation may reduce progression of early, non-calcified plaque. Larger studies are needed to confirm these findings. (Table Presented).