Cardiac structure and function in psoriasis: A cross-sectional analysis of the PSOCADIA study

Abstract

Background: Psoriasis is linked to an increased risk of cardiovascular disease, but the impact of psoriasis on cardiac structure and function has been less clear. Objectives: To assess cardiac structure, function and cardiometabolic risk factors in individuals with psoriasis compared with matched controls and across psoriasis severity. Methods: Cross-sectional analysis of 1010 adults with psoriasis from the prospective PSOCADIA cohort and 1010 age- and sex-matched controls without inflammatory skin disease. Participants underwent clinical assessment and transthoracic echocardiography. Cardiac abnormalities assessed included hypertrophy, valvular disease, systolic and diastolic dysfunction, and myocardial dysfunction defined by global longitudinal strain (GLS) <16%. Results: Despite well-managed skin disease, individuals with psoriasis had more prevalent myocardial dysfunction by abnormal GLS (16.7% vs. 6.0%, p < 0.001) compared with controls. This association persisted after adjustment for cardiometabolic risk factors and atherosclerotic cardiovascular disease. Cardiac structure and function were largely similar across psoriasis severity. Higher body mass index and diabetes were independently associated with myocardial dysfunction in psoriasis. Conclusions: Individuals with psoriasis, even with well-managed skin disease, exhibit a higher burden of myocardial dysfunction compared with controls, independent of cardiometabolic comorbidity. The prevalence was similar across psoriasis severity, highlighting the importance of cardiovascular assessment in all patients with psoriasis. Clinicaltrials.gov : NCT04950218 (Prevalence and risk factors asSOciated with CArdiac comorbiDIty in psoriAsis, registered on 6 July 2021).