Abstract 12608: Coronary Artery Plaque Burden Characterization in Psoriasis Reveals Increase in High Risk Plaque
Introduction: Psoriasis (PSO), a chronic inflammatory skin disease associated with increased risk of MI, provides an ideal translational human model to study inflammatory atherogenesis. The presence of high-risk plaque (HRP) by coronary-computed tomography angiography (CCTA) is associated with prospective CV events. To date, however, no study has characterized HRP morphology in PSO.
Hypothesis: We hypothesized that PSO would associate with an increased prevalence of HRP, as compared to controls (HC).
Methods: PSO (n=107), HC (n=25), and hyperlipidemic patients (HLD) (n=30) who were candidates for statin therapy under NCEP ATP III guidelines, underwent CCTA (Toshiba, 320-detector row) for coronary plaque characterization. Total and non-calcified plaque burden were quantified using QAngio (Medis). To characterize HRP, a single reviewer evaluated for positive remodeling index (> 1.1), low-attenuation (< 30 HU), and spotty calcification. Statistical analysis included multivariable regression.
Results: PSO patients were middle-aged, male-predominant, and at low Framingham risk (Table). Non-calcified plaque burden was higher in PSO than in HC (p =0.05) and in HLD (p = 0.02). The prevalence of HRP was greater in PSO than in HC (34% vs. 8%, p=0.01), and was comparable to that seen in HLD (34% vs. 37%, p=0.78). Logistic regression revealed a significant association between PSO and the presence of HRP, beyond Framingham risk, BMI, glucose, and statins (OR 5.8, p= 0.03). This association, however, attenuated in HLD after adjustment (OR 2.6, p = 0.3).
Conclusions: PSO associated with a higher prevalence of HRP, independent of traditional CV risk, and similar to that observed in HLD. These findings are consistent with the known association between PSO and MI, and may lend insight to the residual CV risk not captured by traditional methods in PSO. Larger studies are needed to confirm these results.
Author Disclosures: J.B. Lerman: None. A. Chaturvedi: None. A.K. Dey: None. T.M. Aberra: None. A.A. Joshi: None. M.T. Kabbany: None. T. Salahuddin: None. R. Yunus: None. J.I. Silverman: None. J.A. Rodante: None. M.P. Playford: None. M.Y. Chen: None. V. Sandfort: None. D.A. Bluemke: None. N.N. Mehta: None.
- © 2016 by American Heart Association, Inc.