Long-term prognostic value of coronary flow reserve in psoriasis patients

Piaserico, Stefano; Osto, Elena; Famoso, Giulia; Montisci, Roberta; Michieli, Laura De; Zanetti, Irene; Iliceto, Sabino; Tona, Francesco

doi:10.1016/j.atherosclerosis.2019.08.009

Cited by 25 publications

(21 citation statements)

References 42 publications

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“…Psoriasis is believed to be an independent risk factor for cardiovascular disease [1,3,15], however, the underlying mechanisms are not fully understood. There is evidence that the reduced resistance of the expanded superficial capillary bed is not solely responsible for the massively elevated blood flow in plaque skin.…”

Section: Discussionmentioning

confidence: 99%

Changes in Microvascular Reactivity and Systemic Vascular Resistance in Patients With Psoriasis

2020

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The aim: of this pilot study was to explore local blood flow in psoriatic plaques and normal skin before and after provocations known to alter cutaneous vascular resistance in order to test whether the increased flow was caused by a failure of normal vascular control processes in plaque skin and what association it has with cardiovascular parameters. Material and methods: 11 patients who had a diagnosis of psoriasis vulgaris were enrolled in the study. Cutaneous blood flow was recorded over plaque and clinically normal skin. 10 healthy sex and age matched subjects were selected as controls. Blood flow in psoriatic and normal skin was measured by a single- channel Laser Doppler blood flowmeter (Blood Flow meter, AD Instruments Ltd., Oxford, UK). Post-occlusive reactive hyperaemia was assessed on the plaque and non-plaque site. Cardiovascular parameters: heart rate, systolic and diastolic pressure, cardiac output, and vascular resistance were continuously monitored by a Finapres (FINAPRES Medical Systems, The Netherlands). Results: In patients, basal-LD flow was significantly higher in psoriatic skin compared to nonpsoriatic skin and significantly higher than in the controls. However, the post-occlusive hyperaemia test did not reveal significant differences between the patients and control subjects. Systemic vascular resistance was significantly lower in patients with psoriasis compared to healthy individuals. Conclusions: The results suggest that reduced microvascular resistance is associated with a significant increase in blood flow of psoriatic plaques and with lower systemic vascular resistance.

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Section: Discussionmentioning

confidence: 99%

Changes in Microvascular Reactivity and Systemic Vascular Resistance in Patients With Psoriasis

2020

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“…Piaserico et al recently stated that CMD is associated with severe psoriasis, psoriatic arthritis, hypertension, and disease duration greater than 6 years, suggesting that this technique is a reliable prognostic marker for patients with psoriasis without a history of CV events. 42) The perivascular fat attenuation index (FAI) is a recently developed technique that uses computed tomography (CT) to allow physicians to evaluate coronary inflammation using differential mapping of attenuation gradients in pericoronary fat. Elnabawi et al 43) demonstrated a https://doi.org/10.4082/kjfm.20.0053 reduction in the FAI of patients receiving biologic therapy for moderate to severe psoriasis, making this a novel tool to evaluate the effects of psoriasis therapy for coronary artery disease.…”

Section: Imaging In the Evaluation Of Cardiovascular Diseasementioning

confidence: 99%

Psoriasis and Cardiovascular Disease: A Narrative Review

2021

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Psoriasis is a chronic, autoimmune, and inflammatory disease that affects 2% of the world's population. In recent years, it has been demonstrated that psoriasis confers a 25% increase in relative risk of cardiovascular disease, independent of factors such as hyperlipidemia, smoking, and obesity. The objective of this review was to analyze and describe the association between psoriasis and cardiovascular disease. In this review, we describe the epidemiological association of psoriasis and cardiovascular disease, pathophysiology, mechanisms, and its association with the well-known cardiovascular risk calculators. In addition, we describe diagnostic tools, such as imaging techniques and novel biomarkers, that are useful in the evaluation of atherosclerotic cardiovascular disease. Finally, we present different systemic therapies that are used in patients with psoriasis and their effect on atherosclerotic cardiovascular disease. This article provides an overview of the current literature on psoriasis and cardiovascular risk, which can be useful for primary care physicians in their daily clinical practice.

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“…[ 51 ] Piaserico et al showed that CMD was associated with severe psoriasis in 15% of the 153 patients in their study (n=23; OR 3.1, p=0.03). [ 52 ] Similarly, the prevalence of CMD has been assessed in psoriasis patients in a cohort study by Weber et al to quantify myocardial perfusion and myocardial flow reserve (MFR) using positron emission tomography imaging. It was reported that the prevalence of CMD (defined as MFR <2) was 61.3% in patients with psoriatic disease, compared to 38.4% in a matched control population (p=0.004).…”

Section: Psoriasis and Coronary Microvascular Dysfunctionmentioning

confidence: 99%

The Association Between Psoriasis and Cardiovascular Diseases

2021

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Cardiovascular diseases and psoriasis have been well established as separate entities, however, there is uncertainty with regards to a link between the two diseases. A few environmental, psychological and social factors have been implicated as potential common risk factors that may exacerbate the two diseases, and an array of complex immune and non-immune inflammatory mediators can potentially explain a plausible link. Pharmacotherapy has also played a role in establishing a potential association, especially with the advent of biological agents which directly act on inflammatory factors shared by the two diseases. This review will look at existing evidence and ascertain a potential correlation between the two.

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Long-term prognostic value of coronary flow reserve in psoriasis patients

Cited by 25 publications

References 42 publications

Changes in Microvascular Reactivity and Systemic Vascular Resistance in Patients With Psoriasis

Changes in Microvascular Reactivity and Systemic Vascular Resistance in Patients With Psoriasis

Psoriasis and Cardiovascular Disease: A Narrative Review

The Association Between Psoriasis and Cardiovascular Diseases

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