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Subclinical Atherosclerosis in Psoriatic Arthritis: A Case-Control Study LIHI EDER, DEVY ZISMAN, MENASHE BARZILAI, ARIE LAOR, MICHAL RAHAT, MICHAEL ROZENBAUM, HAIM BITTERMAN, JOY FELD, DORON RIMAR, and ITZHAK ROSNER
ABSTRACT.
Methods. Forty patients with PsA were enrolled. Controls were matched by age, sex, and atherosclerotic risk factors. All patients and controls underwent duplex scan of the carotid arteries. Carotid intima-media thickness (IMT) was evaluated and the presence of atherosclerotic plaques was recorded. The plaques were graded and carotid plaque index was calculated. Results. Patients with PsA had a higher IMT (mean ± standard deviation, 1.04 ± 0.35 mm vs 0.88 ± 0.29 mm in controls; p = 0.03), and had a higher carotid plaque index than did matched controls (2.3 ± 2.6, compared to 1.12 ± 2.09; p = 0.03). Multivariate analysis demonstrated that PsA status as well as age and triglyceride levels were associated with the presence of carotid plaque. Other traditional risk factors were more prevalent among patients with PsA; however, they were not statistically significant. Conclusion. Our study demonstrates that patients with PsA may have an increased prevalence of subclinical atherosclerosis. These findings may not be solely attributable to traditional risk factors alone. Special attention and strict control of atherosclerotic risk factors in patients with PsA is warranted. (First Release Mar 15 2008; J Rheumatol 2008;35:877-82) Key Indexing Terms:
ATHEROSCLEROSIS
From the Department of Internal Medicine, Ultrasound Unit, and Immunology Research Unit, Carmel Medical Center; Rheumatology Clinic, Lin Medical Center, Clalit Health Service; and Department of Rheumatology, Bnai Zion Medical Center, Haifa, Israel. L. Eder, MD; D. Zisman, MD; D. Rimar, MD, Department of Internal Medicine, Carmel Medical Center and Rheumatology Clinic, Lin Medical Center; M. Barzilai, MD, Ultrasound Unit; M. Rahat, PhD, Immunology Research Center; A. Laor, MD; H. Bitterman, MD, Department of Internal Medicine, Carmel Medical Center; M. Rozenbaum, MD; I. Rozner, MD, Department of Rheumatology, Bnai Zion Medical Center; J. Feld, MD, Rheumatology Clinic, Lin Medical Center, and Department of Rheumatology, Bnai Zion Medical Center. Dr. Eder and Dr. Zisman contributed equally to this report. Address reprint requests to Dr. L. Eder, Department of Internal Medicine, Carmel Medical Center, 7 Michal Street, Haifa 34362, Israel. E-mail: benlihi@gmail.com Accepted for publication December 20, 2007. |
