Psoriasis is a systemic inflammatory disorder that involves complex pathogenic interactions between the innate and adaptive immune systems. Individuals with psoriasis have an increased risk of developing other chronic health diseases such cardiovascular disorders. The high incidence of cardiovascular events in the population with psoriasis could be explained by several mechanisms. The high prevalence of traditional cardiovascular risk factors and metabolic abnormalities contributes to the high cardiovascular burden in patients with psoriasis. Likewise, the presence of systemic inflammation in combination with metabolic abnormalities may act in a synergistic manner to increase cardiovascular risk in these patients. This review focused on epidemiologic and clinical evidence linking psoriasis to cardiovascular risk factors and cardiovascular disease. We described the possible pathophysiological mechanisms that justify this association and analyzed the best way to stratify the cardiovascular risk in patients with psoriasis. We also described the usefulness of the therapies frequently used in cardiovascular prevention and analyzed the impact of the specific psoriasis medication on cardiovascular risk factors or major atherosclerotic events. Knowledge of the application of different cardiovascular prevention strategies could mean an advantage in performing the difficult task of estimating cardiovascular risk and treating cardiovascular risk factors in this particular group of patients.

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Antecedentes y objetivo: Varios informes han demostrado la persistencia de síntomas a largo plazo luego de la infección inicial por COVID-19 (síndrome post-COVID-19). El objetivo de este estudio fue analizar las características de la prueba de esfuerzo cardiopulmonar (PECP) realizada en pacientes con antecedentes de infección por COVID-19, comparando sujetos según la presencia de síndrome post-COVID-19. Métodos: se realizó un estudio transversal. Se incluyeron pacientes consecutivos > 18 años con antecedentes de infección por SARS-CoV-2 confirmada por la prueba de reacción en cadena de la polimerasa y una PECP realizada entre 45 y 120 días luego del episodio viral. Se evaluó la asociación entre variables relacionadas con la PECP y síndrome post-COVID-19 mediante análisis univariante y multivariado. Resultados: Se incluyeron 200 pacientes (edad media 48,8 ± 14,3 años, 51% hombres). Los pacientes con síndrome post-COVID-19 mostraron un VO 2 pico significativamente menor (25,8 ± 8,1 ml / min / kg frente a 28,8 ± 9,6 ml / min / kg, p = 0,017) en comparación con los sujetos asintomáticos. Además, los pacientes con síndrome post-COVID-19 desarrollaron síntomas con mayor frecuencia durante la PECP (52,7% vs 13,7%, p <0,001) y tenían menos probabilidades de alcanzar el umbral anaeróbico (50,9% vs 72,7%, p = 0,002) en comparación con sujetos asintomáticos. Estos hallazgos no se modificaron al ajustar por factores de confusión. Conclusión: Nuestros datos sugieren que el síndrome post-COVID-19 se asoció con un menor VO 2 pico, una menor probabilidad de alcanzar el umbral anaeróbico y una mayor probabilidad de presentar síntomas durante la PECP. Se necesitan estudios futuros para determinar si estas anomalías durante la PECP tendrían valor pronóstico.

(1) Sodium–glucose cotransporter-2 inhibitors (SGLT2-i) reduce adipose tissue and cardiovascular events in patients with type 2 diabetes (T2D). Accumulation of epicardial adipose tissue (EAT) is associated with increased cardio-metabolic risks and obstructive coronary disease events in patients with T2D. (2) We performed a systematic review and meta-analysis of SGLT2-i therapy on T2D patients, reporting data on changes in EAT after searching the PubMed/MEDLINE, Embase, Science Direct, Scopus, Google Scholar, and Cochrane databases. A random effects or fixed effects model meta-analysis was then applied. (3) Results: A total of three studies (n = 64 patients with SGLT2-i, n = 62 with standard therapy) were included in the final analysis. SGLT2 inhibitors reduced EAT (SMD: −0.82 (−1.49; −0.15); p < 0.0001). An exploratory analysis showed that HbA1c was significantly reduced with SGLT2-i use, while body mass index was not significantly reduced with this drug. (4) Conclusions: This meta-analysis suggests that the amount of EAT is significantly reduced in T2D patients with SGLT2-i treatment.

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