Cardiovascular comorbidities in psoriatic arthritis - study of patients from the Republic of Moldova

Abstract

Introduction. Psoriatic arthritis (PsA) is a chronic musculoskeletal and cutaneous inflammatory disease that affects about 20-30% of patients with psoriasis. In addition to musculoskeletal and cutaneous manifestations, patients with PsA have a higher prevalence of comorbidities compared to the general population. More than half of patients with PsA have at least one comorbidity, with up to 40% of patients having more than three comorbidities. Purpose of the study. To evaluate the relationship of cardiovascular comorbid pathology with the clinical and laboratory characteristics of the evolution of psoriatic arthritis and quality of life to optimize patient management tactics. Material and methods. In order to achieve the purpose and objectives of the study, a group of 92 patients with psoriatic arthritis was selected, established in accordance with the CASPAR diagnostic criteria (2006). The patients were treated in the rheumatology and arthrology departments of the Republican Clinical Hospital „Timofei Moşneaga„ and of the Municipal Clinical Hospital „Saint Trinity” in Chisinau during 2017-2019. In order to achieve the purpose and objectives of the research, type 1 cohort study (prospective study with retrospective components) is planned. Results. In the study conducted by us in the 92 patients with PsA, different subjective and objective symptoms of heart damage were determined. This number does not include persons up to 18 years of age and after 60 years, with obesity (BMI > 25 kg/m2 ), diabetes mellitus type I or II, hypertension and ischemic heart disease developed up to the onset of the underlying disease, congenital dyslipidemia, congenital and rheumatic valvulopatii, decompensated cirrhosis of the liver, long-term treatment with glucocorticosteroids (>1 month) or > 1 mg/kg/body (for 2 weeks). The most common pathology was hypertension with a frequency of 38% (35 out of 92). With an established diagnosis of coronary heart disease: exertion angina pectoris - at 5.4% (5 out of 92) and postinfarct cardiosclerosis (CSPI) in 2.2% (2 out of 92) of patients, chronic heart failure (ICC) in 6.5% (6 out of 92) of patients. Combined cardiovascular pathology was observed in 16.3% (15 out of 92) of patients. Cerebrovascular disorders were detected in 3.3% (3 out of 92). Conclusions. In patients with PsA of young and middle age, a high frequency of comorbid pathology was observed: in 60.9% of patients, more than one comorbid pathology was observed, with the highest frequency were recorded diseases of the musculoskeletal system (42.4%), cardiovascular (41.3%) and diseases of the digestive system (41.3%).