A recent study published in the Journal of American Medical Association Dermatology has compared the Coronary Artery Calcium (CAC) scores between psoriasis and diabetes mellitus. Based on its findings, psoriasis and diabetes mellitus both have similar high coronary artery calcification scores.
Psoriasis is a systemic inflammatory disease affecting approximately 2% of the population in North America and Europe. 20 to 25% of these affected individuals suffer from moderate to severe forms of psoriasis which require systemic therapies.
Given the inflammatory nature of psoriasis, it has been shown to increase the risk for coronary artery disease, stroke, cerebrovascular and peripheral vascular diseases. It is also accounted as an independent risk factor for other inflammatory disorders like metabolic syndrome.
Psoriasis carries a high risk of cardiovascular mortality in affected patients and it is the leading cause of death in this group, especially for patients with a severe form of this disease.
On the other hand, diabetes mellitus is also a very serious risk factor for cardiovascular disease as it is classified as a myocardial infarction equivalent. Studies have shown that psoriasis and diabetes mellitus impose a similar risk of atherosclerosis for affected individuals.
Current guidelines from the American Heart Association and the American College of Cardiology recommend coronary artery calcification scoring in 40-year-olds and older with asymptomatic type 2 diabetes for an improved risk stratification.
Comparing the coronary artery calcium score between psoriatic patients and patients with type 2 diabetes mellitus is the objective of a new study which is published in the Journal of Medical Medical Association Dermatology.
A total number of 387 patients participated in this study, 51 of which were psoriasis patients, 52 diabetes patients and 52 healthy individuals as controls. The mean age of patients was 51 years. The mean Framingham Risk Score (an estimate the 10-year cardiovascular risk of an individual) was 9, 8 and 5 for psoriatic, type 2 diabetes and healthy individuals, respectively. Upon comparison of coronary artery calcification, this score was significantly higher in psoriatic patients and type 2 diabetics compared to the healthy controls ( p value=0.003 and <0.001 respectively) The coronary artery calcification score was statistically similar between psoriatic and type 2 diabetics ( p-value =0.45).
The authors have concluded that psoriasis increases Coronary Artery Calcium (CAC) scores to a level which is observed in type 2 diabetics. Since psoriasis and type 2 diabetes have a similar cardiovascular risk profile, this study suggests early cardiovascular risk assessment and risk factor modification for patients with moderate to severe psoriasis.
Written By: Nima Makhdami, M.D.